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Claim, Root, Donald or LindaCLAIM AGAINST THE CITY OF DUBUQUE This written report constitutes your claim against the City of Dubuque, Iowa. You should complete this form in full and attach any additional information that supports your claim. The Claim must be filed with the City Clerk ac City Hall, 50 West 13th Street, Dubuque, Iowa 52001-4864. It will then be referred by the City Council to the appropriate Department for investigation. Once that investigation is completed, a report and recommendation will be submitted to the City Couz~cil. You will be provided with a copy of that report and recommendation. TkU~ FINAL DECISION ON AL~ CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF T~".' CITY OF DUBUQUE HAS T~E AuThORITY TO MAKE ANY REPRESENTATION TO YOU ~ TO W~ET~ER YOUE CLAIM WILL OR WILL NOT BE PAID. 1. Name: Donald or Linda Root 2. Address: 825 West Locust St. 3. Telephone Number: 556 3390 4. Date of Incident: 4 9 2001 5. Time of Incident: Early a.m. 6 - 7:00 6. Location of incident. (Be specific) Water backup thru basement sink due to plugged sewer - overloaded sanitary system. 7o DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give full details upon which you base your claim, if a City employee was involved, give the employee's name.) 10. 11. 8. What were weather conditions like? /u~---:~cl/~' 9. Give name and address of any witnesses. Did police investigate? (If so, give names /JO Was anyone injured? (If so, give name, injuries. ) 12. Was any damage done uo property? (If so, describe property and the ex:en~ o~ da~ge. Attach estimates of damages or describe basis for ascertaining extent of damage.) See attached list. What other d~mages do you claim, if any? 13. 14. Have you been compensated for any part or all of your claim by a~y insLLrance company? - (If so, give name and address of insurance company and amount paid.) 15. What amount do you claim from uhe City of Dubuque? $532.00 16. Why do you claim the City of Dubuque is responsible? Sanitary system isn't big enough to handle the amount of water people are putting into it. 17. Have you m~de any claim against anyone else for damages as a result of this incident? ~O If yes, give name and address: 18. If the answer to Question 17 is yes, have you received any payment from that so~irce, and if Dated au Dubuque, Iowa, this 27th day of April, 2001. /s/ Donald R. Root /s/ Lida A. Root (Signamure) (Print Namel (Revised January, 2000) APRIL 2001 MICHAEL VANMILLIGEN CITY OF DUBUQUE CITY HALL 50 WEST 13TM ST DUBUQUE IA 520014864 Please find the enclosed list of articles damaged in our home the morning of April 9, 2001, due to sewer problems in our neighborhood. The water came up the basement sink and overflowed onto the floor. LuCkily it was/n the furnace room which has a cement floor. The rest of the basement is fzxed up and the damage there would have been greater. I do have quite a collection of expensive holiday decorations that I have accumulated over the years, which are all stored in the furnace room. The thought of loosing more of them alarmu me. A lot more would have been mined if we had not been home at the time. We have lived here for almost 27 years. The only other time we had a problem was in 1993 when water backed up through a basement toilet. We removed the toilet completely that year and didn't expect to have a future problem, but now it is coming up the sink. It is a real worry to have to think about this every time it rains. Several of our neighbors have gotten water in their basements m~merous times in the past - The Eishachs, Aldemang~ Rinikers, Sullivans, Lyons & Ludivossy Ins. It should be evident that the sanitary system serving West Locust is not nearly big enough to handle all the water. Something needs to be done very soon to fLx this problem permanently. We pay tax dollars and take pride in our home. We hate to see things damaged that we worked hard for. I do want to thank the 2 city employees who helped with the shop vac to suck the water up and help move boxes. I do not know their names, but they also helped the other neighbors so I'm sure you could identify who they are. We sincerely hope this matter gets immediate attention and something is done to prevent it happening in the future. Thank You! Donald & Lincla Root 825 West Locust St Dubuque la 520014360 563-556-3390 · *'ITEM~ DAMAGED DUE TO SEINER BACKUP APRIL 9, 2001 DONALD & LINDA ROOT 825 WEST LOCUST ST DUBUQUE IA 52001-4360 556-3390 Xmas salt & pepper shakers $20.00 Lefton christmas carolers $18.00 Lefton christmas caroler $9.00 Lefton christmas santa $5.00 Musical christmas carolers $17.00 Carlton frosty the snowman musical waterball $24.00 Nativity musical waterball $25.00 Hallmark musical waterball $13.00 Christmas tree musical waterball $25.00 Carlton snowman musical waterball $25.00 Dickensville lighted church house $2.0.00 Dickensville lighted house $20.00 Christmas around the wodd lighted snow village $25.00 Dickens lighted bakery $25.00 Trenditions ceramic lighted christmas village $25.00 2 porcelan christmas house lamps $26.00 Storyteller animated santa $60.00 Mary moos #142905 Mary moos # 104272L Mary moos # 104264L Halloween mask - battery operated $10.00 $1o.oo $10.00 $20.00 1994 Sport magazine - 10 years of Michael Jordan$10.00 Additional collectors sports magazines $20.00 Easter bunny waterbali Porcelan easter bunny Wages lost due to cleanup $10.00 $10.00 $50.00 TOTAL $532.00