Claim Givens, James & GenevieveCLAIM AGAINST THE CITY OF DUBUQUE, IOWA
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 at City Hall, 50 W. 13th St., Dubuque, IA 52001. 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 Council. You will be provided with a copy of that report and recommendation.
THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF THE CITY OF DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO YOU AS TO WHETHER YOUR CLAIM WILL OR WILL NOT BE PAID.
1. Name of Claimant: James and Genevieve Givens
2. Address: 2168 Orchard Drive, Dubuque, IA 52001
`
3. Telephone Number: 563 583 8736
4. Date of Incident: April 12, 2006
5. Time of Incident: Between 5:00 A.M. & 8:30 A.M.
6. Location of Incident (Be specific): Bathroom, Rec. Room, Bedroom, Office, Hallway (4), Closets & Garage on Lower
Level of 2168 Orchard Drive, Dubuque, IA 52001
7. 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.)
See Attachment and pictures
8. What were weather conditions like? Approx. 50 and overcast
9. Give name and address of any witnesses: (2) Unknown City Sewer workers: Todd Wiedenman (563 584 2242) and Terry Lenstra of Servpro (563 582 7776)
10. Did police investigate? (If so, give names of officers.) No
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
No, but my wife and I were exposed to raw sewage and the micro-organiams that comes with it. This could cause a health problem..
12. Was any damage done to property? (If so, describe property and the extent of damages. Attach estimates of damages or describe basis for ascertaining extent of damage.)
Yes, carpet and padding in all rooms located in lower level must be removed and replaced.
13. What other damages do you claim, if any? None at this time. However, I will be filling an additional claim should a mold problem develop in our home and should my wife and/or I develop health problems caused by this backup.
14. Have you been compensated for any part or all of your claim by any insurance company? (If so, give name and address of insurance company and amount paid.)
No
15. What amount do you claim from the City of Dubuque? Total $3775.00; $3,480.00 for new carpet and cushion installed by "Floor Show" and $295.00 for removal and water damage drying by "ServPro".
16. Why do you claim the City of Dubuque is responsible? Backup of raw sewage into our home from the City Sanitary Sewer was caused by a large amount
of debris which was later flushed from the city line by (2) City workers.
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.) No
18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount?
Dated at Dubuque, Iowa this 28th day of April, 2006. , 20 .
/s/ James T. Givens
(Signature)
(Print Name)
(Rev. 1/00 & 7/01)
.
Cvbd~ /jL//'{ / /~/~~~
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
This written report constitutes your claim against the City of Dubuque, Iowa. You shoule
complete this form In full and attach any additional Information that supports your claim.
The Claim must be flied with the City Clerk at City Hall, 50 W. 131h St., Dubuque, IA 52001.
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 Council. You will be provided with a copy of that report and recommendation.
THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL NO EMPLOYEE
OF THE CITY OF DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO
YOU AS TO WHETHER YOUR CLAIM WILL OR WILL NOT BE PAID.
1. Name of Claimant: :]/;IY1ES ,/-tND 681/Ev'IEYE G I VEJflS
2. Address: ;;2./ ro R Of<. C J-IARIl ';QIP- I VF. :iJ;BU Qu F .-Lou//! S:2C()/
,
3. Telephone Number: .503 - 5R'3 - ? 7 3 <:6
4. Date of Incident: f1p t2 I; I Z I d-: 0 () 4:>
5. Time of Incident: .3E T W FIdJ 5 ~ o() A /J1 /f-Ii/Z) ?: s{) AM
6. Location of Incident (Be specific): i51ml< {J0J.'t11 ;PCL. /3;OU1J ;;f;.:;;;J/(o()J-t1,
lee JI/1LL \/II (4. ~L i);<A-6 F wJ L c7WE/f ,iF 'E.L
OF ;;2.1 8 W./f WI )/E t.f3u {JUE) . / /)f"UI'I -6:2..00/
7. DESCRIBE ACCIDENT OR OCCURRENCE TtfAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your claim, If a City emp.loyee was InvQlved, give thE
employee's name.) C"' A
cJ;= E d Tf ,r:rCII /'YJ.EAJ I Il;tl D r)/CTl/ RES'
I
8. What were weather conditions like? !l;/IGOX. ~O 0 !i1N''i) o {/Et<CftS T
9. Give name an,Sladdress of anY-.l\Yltnesses:W f/NKA/ {NO el7Y .,..rFWE~ w,,~s
. (.5k3 584 U41t-)_ . ,
!i..VD WtEDFA//11/1N /M/j) 1c::eRY LEAl ,'T1<A tJF r)a~~J<o c5b3 5g2 7116)
10. Did police Investigate? (If so, give names of officers.) No
.
11. Was anyone Injured? (If so, give names, addresses, and extent of Injuries).
No, &/ ?J1 Y J1//~E
/ /
/l/{I D T WEIP./:::. ?,J( pi?SED 70 AAJ1/ ~ 8W,46E A-1/ Z) 7ffir::
/ -,
;jJ1j{C{J - tJ~GAN/5m-s 77fAT Cc711ES ;,()1J7-1 1/, /;-IT $"
Co U L-;) C/'ru .fE /1 'L T1-I P k?LJ/S L.L:,4..J '
12. Was any damage done to property? (If so, describe property and the extent of damages
Attach estimates of damages or describe basis for ascertaining extent of damage.) -
L/E5 - ell f}..PET AN!) 'iJIlD'DiAl6 III ALL RODM 5 LOC.ATED 1M
, I
LoweR L~vr::..L- MAl).?>T i2,F f<EMDUE-D A-N'D R~ f.]L,4CED,
I
No.,
?a77rL . J:t 3775,00
15. What amount i:Io you claIm from the City of Dubuque?
lOt)
18. If the answer to Question 17 is yes, have you received any payment from that source
and if 80, in what amount?
Dated at Dubuque, Iowa this -2 !? day of Ap"c,/ L- . 20~
~.c1 ~~
o _ (Signature) ,
J/i.n1ES' T G, j/EA/-S
(Print Name)
,
.1-. . -.-.
(Rev. 1/00 & 7/0n
ATTACHMENT
This is a summary of the events as they occurred the morning of 12 April 2006 which
caused damage to our home.
Wednesday, 12 April 2006, 5:00AM
I used the bathroom downstairs and remained in the bathroom for approximately 5 mins.
There was no problem at this time. No backup and no water running when I left the
bathroom
8:30AM
Informed by my wife that she went downstairs to the lower level and found the bathroom
flooded and the carpet very wet in the rec room, hall, bedroom as well as two of the
closets. I checked and found that the garage had also been flooded. (There is a floor drain
in the garage). It appeared to me to be a backup from the city sewer system because of
the following reasons;
I) The water was very dirty and appeared to be sewage, not fresh water.
2) The volume of water. There had to be 20/30 gallons of water (sewage) or more on the
bathroom floor, in the tub, in the carpet and on the garage floor.
3) We had used only a very limited amount of water that morning to wash our hands and
make coffee. Less than 2/3 gallons had actually gone down the drain that morning before
making the discovery.
4)
9:00AM
1 called the City Sewer Dept., told then of my problem and asked that they send someone
to check the sewer line on Orchard Drive in front of our house and also on Delicia Drive
along side our house. We are located on a corner.
9:20AM
City crew of two arrives with a sewer cleaning truck. (1 didn't get their names but I'm
sure there would be a record of this event at the city garage). The crew flushed the sewer
line on Orchard Drive and said they found nothing.
I told them 1 was sure our sewer line was connected to the city sanitary sewer line on
Delicia Drive and asked them to check and flush the Delicia Drive line. They did as 1
asked and flushed and removed approximately a five gallon bucket of fragmented rock,
sand, blacktop and mud from the line. (Please see pictures 1, 2).The City crew told me
. - .
this material may be from construction work done last Fall at the corner of Delicia Drive
and Cedar Ridge. This is the next corner up Delicia Drive from our house.
I was told that during this street construction the sanitary sewer had accidentally been
breach and this material could have gotten into the line at that time.
The material removed by the City crew was dumped by them in the gutter next to the
storm drain and I took several pictures.
Apparently, this material had been working down the sewer line all winter and reached
my connection on the morning of 12 April 2006. The crew told me they didn't think this
material would block the sewer line. 1 fully disagree with that assessment. I was told that
the city line is 8 inches in diameter. The volume of material removed was a good 12
inches in diameter and filled a 5 gallon bucket. However, I actually believe it was a
partial blockage and the backup occurred during the time that everyone was getting ready
for work, school, etc. Once the rush hour was over the pressure backed off and every
thing was OK again. But it was too late for me because the damage had already been
done.
In any case this was not cause by an act of God. This was not cause by a storm or heavy
rain fall. It was cause by something that could have been foreseen and prevented. The
City should have inspected and flushed this line after it was breach.
11:30 AM
City worker arrives in a dump truck with a bucket mounted on the front. This worker
shovels the material from gutter into bucket while very closely examining the material.
(See pictures 3 and 4)
(;i \cns. James
2168 Orchard Drive
Duhuque, fA 5200i
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JOB DATE
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SOURCE
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ESTIMATOR OUlS!DE TERR.
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Insurancc:V'/ater [)anlagc drying and removing: carpet
Out"uf-stat.: sale, exempt froln sales tux
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