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23422 78TH AVE W.PDF111111111111 6683 23422 78TH AVE W rk 4 0 STREET FILE April 22, 1981 MEMO FOR RECORD SUBJECT: CLAIM FOR DAMAGES 23412 - 78TH AVENUE W. RON MIZIMORI On March 17, 1981, 1 was dispatched to investigate a flooding problem that occurred when a cap from an 8" water main blew off, flooding the yards of the following residences: 2 3 4 12 , 2 3 4 18 , 2 3 4 2 8 , 2 3 5 0 2 , 2 3 5 0 8 , 2 3 5 14 Upon inspection, the only residence to sustain a heavy amount of damage was 23422 78th Avenue W., in which the yard was flooded as well as the entire area under the residents house. All residences' yards, with the exception of 23412 78th Avenue W. were cleaned by City crews, 23412 78th-Avenue W. was not cleaned as there was little yard damage, only a lawn mower that was flooded by the water. I talked with Mr. Mizimori and advised him that if he were going to file a claim that he was to do so with the City Clerk's office. There also was flooding in a parking lot to an apartment com- plex located on 236th and 7800 block. City crews swept the parking lot and the apartment manager seemed satisfied. LO/gdl I? _q _,Y� 1�2 - 7 f 64 1!:�� , 6'(-) - RECEIVED APR 22) 19�81 Edmonds City Clerk CLAIM FOR DAMAGES NOTICE Claim MUST be presented to the City Council and filed with the City Clerk within 120 days from the date of Accident or Accrual of Damages. TO THE CITY COUNCIL OF THE CITY OF EDMONDS: PLEASE TAKE NOTICE, THAT (if married.dgive husband's —me) wHo mw RESIDES AT ;� 3 '2 9 26) _'�' hl'-= -, J (State present actual address by street, number and city) AND WHO FOR SIX MONTHS PRIOR TO DATE OF ACCIDENT HAS RESIDED AT 4 (Give residence by street, number and city) CLAIMS DAMAGES OF AND 17M THE CITY OF EEMONDS IN THE SUM OF 8 f19, rl arising out of the following circumstances: Describe Claim, giving 4. nAlrr A -IPTL#r 4 J ' njury or damage occurred, PLACE and full particulars. 36. Accurately locate and describe defects caus- ing injury or AamA e and a,11 acts of negli- gence claimed. 77 _b _7 3 accurately descr-ibe injuries or damage State items of As -A e claimed. Itemize all expenses and losses. (Claim atuat be ovorn to by ela' ment) �71 Q A Ir 771 SUMCM0 AND SWORN TO (Signature o7ai�ant) before me this day of Notary Public in and for the State of Batbington, residing at APPLICATION for The City of Edmonds S11)E SEWER PERNaT WR E" FILE OUTSIDE INSIDE E) REPAIRS E] CARD No . .... --------------- EASEMENT No . ................. .................... 2LLI QOY 0 CONTRACTOR ........................................................... ................. ................ ..... PERMIT N OWNER.C. A.rle-S... k I - HOUSE No. ajqa.2.-- STREET ...... ... ...... -------- ...... AVENUE LOT No. ...4/ ....... BLOCK No . ............................................... NAMEADD . ......................................................................... .................................................... - --- - ---- . ........ ... 0 9 BACKPILL SEWER WO] NOTICE: No warranty of accuracy. The information shown on the attached map(s) was compiled for use by the City of Edmonds, its Employees and Consultants. The City of Edmonds does not warrant the accuracy of anything set forth on these map(s). Any person or entity -requesting a copy should conduct an independent inquiry regarding the information shown on the map(s), including, but not limited to, the loc.ation of any sewer stub shown. Such sewer stubs may or may, not exist and may or may not exist at the location shown. Neither the City of Edmonds nor its employees or officers shall be lia-ble for the information given on this map(s), nor for any one representation provided based upon said map(s).