Loading...
HomeMy WebLinkAbout2006-08-01 Appointment c::n NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy - Unexpired + 5-yr Term Ending December 31, 2011 The powers and duties of the Airport Zoning Board of Adjustment are: 1. To hear and decide appeals where it is alleged there is an error in any order, requirement, decision, or determination made by an administrative official in the enforcement of the Airport Zoning Chapter. 2. To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which such board is required to pass under the Airport Zoning Chapter. 3. To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning Chapter as will not be contrary to the public interest, where owing to special conditions a literal enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship, and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets at the call of the Chairperson. Applications must be received by 5:00 p.m., Wednesday, July 26, 2006. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment shouid be directed to Randy Hartwig, Airport Commission Chair at 337-2101. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step- child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: 0 Council Announcement Date: June 13, 2006 Application Deadline: Wednesday, 5:00p.m., July 26, 2006 Council Appointment Date: August 1, 2006 AIRPORT ZONING BOARD OF ADJUSTMENT One Vacancy - Unexpired + 5-yr Term Ending December 31, 2011 Carl Williams resigned No applications as of Wednesday, 5:00p.m., July 26, 2006 [R] Denotes applicant completed the Confidential page of the application. ------_._--~---_._--_._---.,-~--------_.- .-------------.---.--.-----.----- o:J NOTICE THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING COMMISSION One vacancy - Six-yr Term January 1,2006 - December 31, 2011 Duties of the Airport Zoning Commission are: 1. To recommend amendments to the current Iowa City Airport Zoning regulations, including the repeal thereof. 2. To recommend the adoption of new Airport Zoning regulations. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets as required. Applications must be received by 5:00 p.m., Wednesday, July 26, 2006. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Airport Zoning Commission should be directed to Randy Hartwig, Airport Commission Chair at 337-2101. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in-law, sister- in- law, step-father, step-mother, step- child, aunt, or uncle. (Resolution 85-354) Males: 4 Females: 0 Council Announcement Date: September 20, 2005; November 1, 2005; December 13, 2005; January 23, 2006; February 28, 2006; March 21, 2006; April 18, 2006; June 13, 2006 Application Deadline: Wednesday, 5:00p.m., July 26,2006 Council Appointment Date: August 1, 2006 AIRPORT ZONING COMMISSION One Vacancy - Six-year Term January 1, 2006 - December 31, 2011 Term expires for Mark Anderson No applications as of Wednesday, 5:00p.m., July 26, 2006 [&I Denotes applicant completed the Confidential page of the application. 0:0 NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HOUSING & COMMUNITY DEVELOPMENT COMMISSION Two Vacancies - 3 year Terms September 1, 2006 - September 1, 2009 Duties of the Housing and Community Development Commission inciude assessing and reviewing policies and planning documents related to the provision of housing, jobs, and services for low- and moderate-income residents; reviewing policies and programs of the Public Housing Authority and Community Development Division and make recommendations regarding the same to the City Council; reviewing and making recommendations to the City Council regarding the use of public funds to meet the needs of low- and moderate-income residents; housing policies and programs, and seeking public participation in assessing needs and identifying strategies to meet these needs; recommending to the City Council from time-to-time amendments, supplements, changes, and modifications to the Iowa City Housing Code. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. When possible, Council will appoint persons with expertise in construction and/or finance, a person receiving rental assistance, and a member of the Local Homeless Coordinating Board. The Housing and Community Development Commission will have monthly meetings. Applications must be received by 5;00 p.m., Wednesday, July 26, 2006. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Housing and Community Development Commission should be directed to Tracy Hightshoe, Community Development Planner at 356-5244. I I I i , Housing & Community Development Commission I I , I Attendance Record i 2006 I I I Term I Name Expires 01/19 02/16 03/09 03/23 03/29 04/20 I Brian Richman 09/01/07 X X X X X X Jerrv Anthony 09/01/08 X X X X X X Kelly Mellecker . 09/01/08 OlE X X X X X Lori Bears 09/01/07 X OlE X -- -- -- -- -- -- Matthew Hayek 09/01/07 OlE X X X OlE X Michael Shaw 09/01/06 X X X X X X Thomas Niblock 09/01/08 X X X OlE OlE X William Greazel 09/01/06 OlE X X X X X Yolanda Spears 09/01/06 -- -- X -- -- -- -- -- -- -- -- Key: X = Present 0 = Absent OlE = AbsentlExcused NM = No Meeting -- -- = Not a Member I I Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister. in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 4 Females: 3 Council Announcement Date: June 13, 2006 Application Deadline: Wednesday, 5:00 p.m., July 26,2006 Council Appointment Date: August 1, 2006 HOUSING & COMMUNITY DEVELOPMENT COMMISSION Two Vacancies 3-yr Terms September 1, 2006 - September 1, 2009 Terms expire for Michael Shaw, William Greazel Rebecca McMurray IRI 1904 Gleason Ave Kara Schroeder IRI 1205 Laura Dr #155 John McCormally IRI 1408 Prairie Du Chien Rd Michael Shaw 2470 Lakeside Dr #11 IRI (Currently serving unexpired term) Steve Crane IRI 2301 Jessup Circle Karyl Bohnsack IRI 3021 Wayne Ave IRI Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM J! 1 -...."" -~ ~~W~'t . ""'" "',",I~ ...,..~ CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME HDUS I ~('t 4 l'.t>N\r(\. l)6\). NAMEj(f'.REtt--A ~L~ HOMEADDRESS~ GLE"ASDlJ A-J(;. Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? d 4t:::'PtR.::5 OCCUPATION~L>b€N-r) m5LU EMPLOYER PHONE NUMBER: HOME BUSINESS !2{] Yes TERM3/DIo -61 of( o~ ZIP SQ,Q LJ 0 DNo "-' o g 0.... :2:c"") c~ :;> ~"=::'i :;'" Il () ~(-:: /~. - ~,' I G'> EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: r< 8T oc::-/--, ;;> ~O;- " ::tt: ~l ' \ N :C CcrI\PLE. '\~D F 1lR .,. \\€ I ()'IPA GltbLlf' 9tzo ~E;c."l :r M~N1DR..E'b PI Svt>f'lI',H::SE C-l-\lL't> w \-\1> LI-iE:{) fl-\IOF\5F\t-:>"I" fZ I'\:> 6E. Cbm ?1.:e:JI. :50:::t: A-(Y\ fh..uAR.~ tJ-e~y.s Dr "'fMSv~f{lLlNiTl{ IN :L.,,~I"\ CA,,\ A NcE'!>S As.se:.-s.s (Y'\'CI'-IT AND F!e-'1IDN -':>LAtJ enl\ 1-\w51~~ Yf'L./..DW5H If> B s PAi2-~ bY. A.. 1,J "'fHE: ClF THE: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? J:. AM rAm \ L I AIZ \..01 ,1-\ ~i IL{ S-rE:P.s J:. \\,{>,\I& 'Rg,...,,:> ""'l-l~ 'b,.)",IES cNG/..DSeD L0iTl-I f'lPPLlc.ATJDJ Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2005 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? elf J:> L)"f I ,; S of' As P. f'V"T'l5f.Le'. 5oe..d~L 10~~_PQD'II1't>\NGt f\DOS\NGt) ~B5 f\rfD SC:J1..-11eE.5 ~ J~ Low"'1D f/\D't>~[2..PiTe IN Cb'OE 1~!>I,h\;:l)PlLS 11t-:>"t> ~f\(i\\L\f:S \'5 \((\PDR\fI~\ \0 ME: A~'!V ~1...s6 or-:> "rH\ So toM ('(\\S5 I br-J woo L. D f\ LL tt...u ({rb ....0 t' 51 '"(II! IIY'\ C; l-\I::S Po VI.. M'1. f'tRs~EC.;ll\JE. As AN It-.Jb\I\\\:>uf'lL.. Wl\D PRE\IIOO'SLi wA'S lOL0 \~c.DME AN~ LI~Et> IjJ {.\ \-\IQH U-1N1~.f\12.t:.~ 6t:",.;I6P'Ic..d\L \ t-i e.-Dl'I\?t...-E""'\t.,..)Gt ItlE:'" "'( .-\(. Cof'{\('(\ \ 50s I eN . WII...L. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes. being a board member or employee of the agency. .other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. C) ;?.:(j T>--. !,-.; c-":,:''::'' C~::> C,"' c.. c:: ::L; 11 (--, '-. ",' --..I I O. ;-- ""D -,... :-n ( ---j ...._...~.. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? IX IYES DNO ~ .. DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES j N rKJ NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2005 .Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING I! I -- = -~ ~~Wi!':'t :::-' ....J~ ................... CITY OF IOWA CITY Name of City -.ll ~ Board/Commission' DU Sl~ ('1 ANT) nffiffioNl f\ De~. Name~1ZEBE(,f'A f(1Cft1uR.Rf\~ Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). Date lo/Io! /)( 0 List all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdingsl. Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS "- '/h~E.. . r, '" ~ ~O 0'. > r r~,~;:' ..'''~ ~, , ) I ::jC C1\ .- c- ';9; =2 " ~I ,--, ". ~/' ry '.,j - ~ NOTE: A new form must be completed if the above information changes or an ownership interest ~-" ;~~'"'~~"'~1"'~ Address } qo~ 1Le__ ~--'--___ ~-r~~ /i9{)LJO Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2005 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 11, 2005 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (low income) Income 1 $15,250 $25,400 $30,500 $40,600 $50,800 2 1 7,400 29,000 34,800 46,400 58,000 3 19,600 32,650 39,200 52,200 65,300 4 21,800 36,300 43,600 58,000 72,600 5 23,500 39,200 47,000 62,650 78,400 6 25,250 42,100 50,500 67,300 84,200 7 27,000 45,000 54,000 71,900 90,000 8 28,750 47,900 57,500 76,550 95,800 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, AS REQUIRED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, PLEASE INDICATE IF YOU ARE A MEMBER OF ANY OF THE FOLLOWING CATEGORIES: D Senior Citizen (62 or older) D Handicapped or Disabled D Person of Color D Receive Rental Housing Assistance D Lower Income (see table) D Member of the Local Homeless Coordinating Board Your response is voluntarv, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council will appoint a person or persons with expertise in construction and/or finance, a person receiving rental assistance, and a person from the Local Homeless Coordinating Board. If you have expertise in construction or finance, please describe your experience and/or training. :~.:: 0 c.,.-:..:: '::"~:) ~..... ~ (, e :> -n r~-) I .-, , en ~-< .' -n r-:: -u "--'.'1 " , (~-!- ~-"-' '-.......) ~ "" ~- ):> .r:- HCDC Application February 2005 page 4 of 8 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM J ~ 1 -....= -~... ~~ij!i;!:~ . ~~ ~...~ __ &.lL. CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteerS. This form may be filled out manually (please use a black ink pen), typewritten, or' electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONFIDENTIAl." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. , .7" ADVISORY BOARD/COMMISSION NAME .~;. :Jc /,/))/72 j NAME ))/1,k"'/-l Jt'i..nELXR HOME ADDRESS );(/'(') .L4L1-:?, 7)/2.=/5(5 .:LC- Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? ('5/)).0. OCCUPATION I iA fJ/fIN/zcl-ofr-:- /.J/)fccJ " / PHONE NUMBER: HOME &0 {) J - 1/' 7 ~~) 7 ycC-. if 'jl!)f.",,--trERM / iT (\j.r "^,-, i I BYes ZIP ,&) :J.-Qt/5 c[]NO~ ~o c_ P::::: ~ 11 , \ -~c-..:, ~ I (,~-~,:. N -~ -" 5/"- EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: j> ;:; Sf, _\;h10rF'ih~C::'RCI'::fc.J, Si,t' Lt"ci2..,Cl",d,l')!< \,FleW <.J - L i ~c c-i2- ClA::>V1 J1\1'\K'iA :S!\nz..~f2...jl1~l..l"Y~i,ki':'Z:....)b..-"; - 'l/Z>i)"SL PiJ?'2-C/('<,j<. e(h.t~/<, [;i2 ~l>..b/rL J!l::SlSiR:Jt IJJi.4 b\~"f~ -(),R'E.c1b\C 1\,2' h-tA L S V<:. - ~1 1 ~ ) j2r~~,ko1<'- _ ~Z-~-\: (}'A~tC?k~'.<K ~p- \l'\b~,c. lV7j!L\I~~J - ~iR~,C(~f~) ~li~h,<P tbi..c:;:c,L' (1~..c~.C{ lJ\.')-dj5k:.:- <f.~KlRA,)t b0RI-kp,- FhioqRiAlpJ.{::<' -''t1'?i50J3jJ;::' SUc6 '-- 'Bvl'f:J<LL b mE ~ <"Co":. . ".. =? ~ ::.0' I .,.~ , c' , ..;., - - \ EMPLOYER C": BUSINESS WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? , , ) '(C'l ....::'Cc\: -k.JlY. ",-" 'tt--,,, fe'? .. ~r-):': f7!'t." A.d I )lz.. t..o/-i rc.q, ~.y. Misrepresentations on this application will constitute just cause for rempl>'ilf Of I~n'~ppointee. If you fail to answer all the questions, Council may not consider your a~'flib~~i'on. HCDC Application February 2005 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPL YINGI? A.~~ -r- Mt<\lJ<.:_ bnh',i-'i'~'>1r^RJR.R':"d-i~:dr'fi'IJU{€--j +~ (A,IA ,,-'d cJ?lE: cll\14,IIE,i",-~1U -\-1\<:">'0<\ 'IJ)I-:'::; ':'" z:rh11'C' j,--~ :') L, C l, f) <b - A..q;..'jC dR b l b:f-t . " C,J lJCl6\.:',d lORd -clj~("lC'))JUA>>lf(DU ltJ1.1L:d" C FI P b'le'e~ C;;"~Jl b ~ ct n:tNC'c. G k..ft"'C'h.." r . \ 07" :".i.C"c..1 F{", ( '--..J POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes. being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office, You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. j(/ /J o :;0-:0 :r; ::"'1 '0 C..-:;:l c., C~ c. ,= -..... Il () -, I -..J -O;J '--ri .~ -....~J ~) ~.> IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? W-VES DNO 5> DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES o w ~O (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2005 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING I ~ I :::::.n.-...;~.. !:~w!:~ ::-~ ..~t~ ___ &a- CITY OF IOWA CITY Date 0- 7-0'" Name Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS /1/od~ (.....~~ Q '.:-::') ...~-- 0."', ..J....-J '-- - ;;;1'"' J ~J( - I -.J ..: ~--". ; 1 r; i ""t) - r-",,\ _^. " I ~/< N )> 0 A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Signature))'Q /~ '~1~ !\A~zd~ '\2 Address j j:J/"J/-) --I:/-1ili<?I-'} JR. Ie NOTE: /)'oQ~~) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2005 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 11, 2005 Household 30% Median Income 50% Median 60% Median 80% Median Income . 'Median Size (Poverty Level) Income Income (low incomel Income 1 $15,250 $25,400 $30,500 $40,600 . ' $50,800 2 17,400 29,000 34,800 46,400 58,000 3 19,600 32,650 39,200 52,200 65,300 4 21,800 36,300 43,600 58,000 ,72,600 5 23,500 39,200 47,000 62,650 78,400 6 25,250 42,100 50,500 67,300 84,200 7 27,000 45,000 54,000 71,900 . 90,600 8 28,750 47,900 57,500 76,550 95,800 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT' COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, AS REQU'IREPBY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, PLEASE INDICATE IF YOU AftE' A MEMBER OF ANY OF THE FOLLOWING CATEGORIES: ',' D Senior Citizen (62 or older) ~dicapped or Disabled D Person of Color ~eceive Rental Housing Assistance ~~ower Income (see table) D Member of the Local Homeless Coordinating Board Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council will appoint a person or persons with expertise in constructiori and/or finance, a person receiving rental assistance, and a person from the Local Homeless Coordinating Board. If you have expertise in construction or finance, please describe your experience andfoi training. ~kf) f'~f?' I' mJ0IiJf)'l~;C , (}e,RJlJf k'JR,hl< -k;1!- Ay..A.pf?~r;+'6. => 0 0,:;;;:;) oc.. 0" "'~ ~ ,- s ~.~ '- il "',--, C) - . 1 ,- ---.~ -..J ~., -< ". ! \ i'" v ~J 5 .-J-..' ::1= -S /-:.,: N )> 0, . C>) HCDC Application February 2005 " ':~'.~'~ . '~';;~'.f,~,,_ page 4 of 8 '.,:.' :';". ,~ JUN. 7,2006 4:11PM US ATTORNEY OFFICE NO. 1765 p, 2 CITY OF IOWA CITY . ADVISORY BOARD/COMMISSION APPLICATION FORM I! I -~'=.;'" ;t~w. ~~ -...," ................. A _ CITY OF IOWA CITY Individuals serving on Boards/Commissions play an Important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment' is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pent, typewritten, or electronically (PDFI. Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONFIDENTIAL" THIS APPLICATION Will BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICAllY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME Housing and Community Development Comm. NAME John McCormalJy HOME ADDRESS 1408 Prairie Du Chien Rd Is your home address (listed above) within the corpor!lte limits of Iowa City? [l]Yes How long have you been a resident of Iowa City? 1991 CHS grad, moved back May '05 OCCUPATION law student EMPLOYER intem/Johnson County Attorney PHONE NUMBER: HOME (319) 248-9636 BUSINESS (515) 491-5420 TERM 2005-200~ ZIP 52245 DNo EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSrnON: I hold a Masters Degree In Public Policy and have experlence working on the unique problems facing municipalities. I have worked in the lows Legislature and on numel'Qus legislative campaigns. Prior to moving back home to Iowa City, I worked as a journalist, and was exposed to a wide va~ety of people and expe~ences. On a more personal note, I grew up in a low-Income trailer court in Iowa City. As a high school student, I benefitted from the programs at UAY. I understand the importance of community development programs, and consider the enhanoement of opportunitiee for disadvantaged individuals to be one of Ihe most important missions of government. o ~Q ,_.> ", ~ c..:;) .,:".., C~.. c:: -n '-) WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?-<~' " ,-r: My knowledge of the board is limned to what I have gleaned from reviewing the agendss and minutes p~itc~n ~ily <J websne. I am familiar with many of the programs that the board works with, inclUding Habitat for Human!!i UAY, GOodwill. and ~~ m Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2005 Page 1 of 8 JUN. 7.2006 4: 11 PM US ATTORNEY OFFICE NO. 1765 P. 3 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD lOR STATE REASON FOR \PPLYINGI? As previously staled, consider the enhancement of opportunities for disadvantaged individuals to be one oflhe most important missions of government. With experience in public policy and communication, I feel I can bring a unique perlipectlve to the board. I would hope 10 use my experience 10 increase public participation, and to use my education and public commamenlto further the goals of the board. As an Iowa City nallve, I would like the chanee to give back to the community that afforded me so many opportunitias and positive experiences growing up. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employar, In particular, if you are applying to be.a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies .hat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. "ther types of affiliationa must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of e city Board or Commission from having an interest In a city contract, A copy of Section 362.5 is attached (see page 7). If you are uncertain whether a potential conflict of interest exists or have questions about Seotion 362.5 cif the Code of Iowa, please contaot the City Attorney's office at 356-5030. As a student I have no confiicts of interest with the board, ~..: 0 C::I ~:.) <;: c.>" ~,::::Q '- ~~ 11 ~) I c. --.J ,.< r ;'.Tl rr ::? - r __.__, lit has been Council policy not to permit an Individual to serve on two Boards or Commissions at the same time.! Misrepresentations on this application will constitute Just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Applioation Februarv 2005 Page 2 of 8 JUN. 7.2006 4: 11 PM US ATTORNEY OFFICE NO. 1765 P. 4 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING I ~ !, -~--8. !~iii.:UI~"I!;:-r. ;:~"".,' ....,.. CITY OF IOWA CITY Name of City . . Board/Commission Housing and Community Development Comm. Name John McCormally Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). Date 06106/2006 List all businesses In which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS none "" o=c =, c.:::::. :;~:O L_ / , ";- ,..---.., ~-,,-- "j '.~. -.I , --j --< ~ r1i ~ --;' -'" '-'- ;:-, ~ ""5.. .P co -T1 " 'Tl , ' ~ <\..J NOTE: ,f the above information changes or an ownership interest iness. Signature Address 1408 Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2006 Page 3 of 8 JUN. 7.2006 4:11PM US ATTORNEY OFFICE NO. 1765 P. 5 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 11, 2005 Household 30% Median InGome 1i0% Median 60% Median 80% Medien Income Median Size {Poverty Levell Income InGome (low Income) Income 1 $15,250 $25,400 $30,500 $40,600 $50,800 2 17,400 29,000 34,800 46,400 58,000 3 19,600 32,650 39,200 52,200 65,300 4 21,800 36,300 43,600 58,000 72,600 5 23,500 39,200 47,000 62,650 78,400 6 25,250 42,100 50,500 67,300 84,200 7 27,000 45,000 54,000 71,900 90,000 8 28,750 47,900 57,500 76,550 95,800 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, AS REQUIRED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, PLEASE INDICATE IF YOU ARE A MEMBER OF ANY OF THE FOLLOWING CATEGORIES: D Senior Citizen (62 or older) D Handicapped or Diaabled D Person of Color o Lower Income (aee table) o Receive Rental Housing Assistance O Member of the Local Homeless Coordinating Board Your response is voluntarv, and you may wish Instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in anothar aection of this form. When possible, Council will appoint a person or persons with expertise in construction and/or finance, a person receiving rental assistance, and a peraon from the Local Homeless Coordinating Board. If you have expertise in construction or finance, please describe your experi~nce and/or training. I have served as a fund-raiser for several pomical enUtiss. While not 'finance" in the banking sense. thi't':!'perien@gcould be beneficial in the event of a eommunily fund-raising drive. . ;2: () ;: j>::'-, ~ 11 :~ I ---" --J ~'"-< ,:" :::2 --'.... i'-rl r-- n~}} o.,.J-- -' /, ::? )> r- ,""-', , , '-.-" HCDC Application February 2005 "" page 4 of 8 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION ..~PPLlCA TION FORM I ~ I ~~ - ....at... f~w!:'"y. -.;;;:;.... .....,~ ......~ CITY OF IOWA CiTY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen). typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED .CONFIDENTIAl." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME Housing and Community Development Commissi.. TERM ending 8/31/09 NAME Michael Shaw HOME ADDRESS 2470 Lakeside Dr. #11 2lP 522~ [LIYes ~ dNO~ ;- r= 11 -~,._, I -- __..:;/"...... -J I EMPLOYER Iowa Coalition~~flirist Dom. \/iOn \\' :;.. \ " BUSINESS (319) 358-6691:5 :JJ -"j __ J'''-. ~ ;:.., '-" EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? 17 years "r;CUPA TION Social Worker PHONE NUMBER: HOME (319) 338-5567 I received my Bachelor and Master of Social Work degrees from The University of Iowa. I am currently the Director of the Safety and Accountability Audit project for the Slate of Iowa. I am a social worker committed to local community organizing and individual empowerment. I am also a member of the Housing and Community Development Commission and participated in the just completed funding cycle. As a former family support worker at Grant Wood Elementary School, former Board member and volunteer at the local domestic violence shelter, current member of the ICHA-Self Sufficiency-Planning Coordinating Committee and a long time Southeast side resident I have become keenly aware of the housing and community needs of Iowa City. I believe my academic, professional and personal experience qualify me to be a member of the HCDC. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I am a sitting member of the HCDC. My current term ends August 31, 2006. The HCDC is an Advisory Board of the City of Iowa City established to assess and review housing and community development policy and programming. This Advisory Board makes recommendations to the City Council and consults with other city entities about the use of public funds for low and moderate income residents. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2005 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? , am a long time resident and parent in Iowa City. I have owned homes and rented here. I have worked and volunteered in this community for close to 2 decades. Iowa City is my home. The Southeast side of Iowa C~y is where I choose to live and raise my children. I am invested in strengthening all of our communities. I am committed to supporting the vision of the HCDC to create a safe, vibrant and supportive community for low and moderate income families in Iowa City. As a member of the HCDC I believe I can continue to accurately represent the voices of traditionally underrepresented populations and support them in advocating for their interests in local decisions. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies "' lt apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. ~.her types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). If you are uncertain whether a potential contlict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. "" C:l I am currently a member of the ICHA-Family Self Sufficiency-Planning Coordinating Committee. Thougtl'ih~ is @.apparent direct conflict of interest with my role on the Planning Coordinating Committee the appearance of conflicrrlS JlI'!>serjEls ther! ICHA regularly applies for and receives funding from the City as a result of HCDC recommendations. "'. -< I __ ---,r-' -J -~,.... J '-<1-- '[":~ > :::!: ~5~ ~- n ;-.--' ~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [Z]YES DNO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES ... \.0 [Z]NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2005 Page 2 of 8 BOARD. COMMISSION. & COMMITTEES BUSINESS LISTING I ~ J .::::.::..-10.... ~~w;t:~ ":' ....., ..... .. CITY OF IOWA CITY Name of City Board/Commission Housing and Community Development Commission Name Michael Shaw Section 362.5 of the Code of Iowa generally prohibits. with certain important exceptions. a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attach~d (see page 7). Date 07/07/2006 List all businesses in which you or your spouse/domestic partner have an ownership interest (for example. sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS N/A '"" ....~ ~n C7' :,."'? L- ):;;>- . -::~ -< I ']C -J : - , .'t--n ~ , "--~--', ~- , ,,;::::../"':: .- ~-".. --- ..P ~ 1 J NOTE: A new form must be completed if the above information changes or an ownership interest is acquire,! in an additional business. Signature ~ ~ Address 2470 lakeside Dr. #11 Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application February 2005 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 11. 2005 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (low income) Income 1 $15.250 $25.400 $30,500 $40.600 $50,800 2 1 7.400 29,000 34,800 46.400 58,000 3 19,600 32,650 39.200 52,200 65,300 4 21,800 36,300 43,600 58,000 72.600 5 23,500 39,200 47,000 62,650 78.400 6 25.250 42,100 50,500 67,300 84,200 7 27,000 45,000 54,000 71,900 90,000 8 28,750 47,900 57,500 76,550 95,800 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, AS REQUIRED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, PLEASE INDICATE IF YOU ARE A MEMBER OF ANY OF THE FOLLOWING CATEGORIES: D Senior Citizen (62 or older) D Handicapped or Disabled 0' Person of Color D Receive Rental Housing Assistance D Lower Income (see table) D Member of the Local Homeless Coordinating Board Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council will appoint a person or persons with expertise in construction and/or finance, a person receiving rental assistance, and a person from the Local Homeless Coordinating Board. If you have expertise in construction or finance, please describe your experience and/or training. (2 ~;g ,...., C.-.:::> = a"' '- c:.: ~ --n HCDC Application February 2005 -, d ._,,-~ -"'1'" -' .<r.-' r~-' ~~~~ <- :: II ".-, J I --.J i- U) page 4 of 8 CITY OF IOWA CITY l\DVISORY BOARD/COMMISSION APPLICATION FORM I t 1 ~.~'t "'-.. -"'m~ -.......... CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meating. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPliCATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME Iowa City Housing and Community Development TERM September 06'-{)9' NAME Steve Crane HOME ADDRESS 2301 Jessup Circle Is your home address (listed above) within the corporate limits of Iowa City? [{]Yes How long have you be&ll a resident of IOWa CitY? 12 years "'CCUPATION Commercial Benking Vice President EMPLOYER Bankers Trust ZIP 52246 DNo PHONE NUMBER: HOME (319) 338-9306 BUSINeSS (319) 331-9306 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: As a commercial lender, I financed several low to moderate income projects in the Cedar Rapids Area. Our bank, Bankers Trust, is opening an office in Iowa City In 2007; we are very committed in helping low to moderate income families when they seek financing. As a resident of Iowa City, I know rising real estate prices and an increase of lower income families into the area has made affordable housing a large issue. My Undergraduate degree from the University of Iowa Is Sociolog~J'nd I enjoy working with people in different, social classes and being able to help them reach their goals. 0 c5 _ 0' ~t:::n ' , .$ r- N Ul il I ,-ri "._-, WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ..c.;::''''<' 5> N I would assume this is a very active board because of the greet demands and needs of the influx of low to moderate income families in Iowa City and I would be very dedicated to volunteer my time and efforts in meetinglhese needs and sharing my input. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application June 2006 Page 1 ot8 1 . d 8Ot8'0N 6090-998-618 ~V19 : II 900 Z . 9 Z . 1 n r WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR 'PPLYING)? I feel 1 would have solid credibility when dealing with families and other organiZations when discussing financial assistance needs. I strongly beliave in helping the low 10 moderate income class in their efforts to better themselves and would be very dedicated to the cause. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership Dn the advisory board and your personal interests. including financial interests and your duties tD an employer. In particular, if you are applying tD be a member of a board Dr commission which makes recommendations to the City CDuncil about the allDcation of City funds, please list any present affiliatiDns YDU have with agencies at apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. ,-,ther types Df affiliations must be examined Dn a case by case basis by the City Attorney's Dffice. You should also know that Section 362.5 Df the Code of Iowa generally prohibits, with certain important exceptiDns, a member of a city BDard Dr Commission from having an interest in a city conuact. A copy of SectiDn 362.5 is attached (see page 71. If you are uncertain whether a potential conflict of interest exists Dr have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. r:::.~ 12 '--:"':> O. ~O '-.. .... ):> =-~:::-. c: $ -. r- Il ~-) N (. (Jl . ". f- iTl '. ::::.,. r~ _'.J \-~:;- '--' :';;~ ,", )> IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 0YES DNO N DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES [{] NO (It has been Council policy not to permit an individual to seIVe Dn two Boards Dr CDmmissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application June 2006 Page 2 of 8 Z . d 80t8'0N 6090-998-618 ~m : II 900 Z . 9 Z . I n r BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING I! ,I -- -, .~... J.:~w~"t. -...;:... ~...~ ~...... r CITY OF IOWA CITY Name of City Board/Commission Iowa Cily Housing and Communily Development Name Steve Crane Date 07/25/2006 Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which yoI' or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdlngs). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS ,~ 0 .:..'~ <'" .::;.>-.. ::r; .::! := TJ n -. . ~. ,= .,~ (: n ' - "'" s~~~ -, /--) - "'- .. )> - ,~ , ,~ NOTE: A new form must be completed if the above information changes or an ownership interest _ is)/qUir~ an rd:nal business. Slgnatur~ G' Address 2301 Jessup Circle Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer allthe questions, Council maynot consider your application. HCDC Application June 2006 Page 3 of8 8 'd 8m'oN 6090-998-618 NVI9: II 900Z '9Z'lnr TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 8, 2006 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size IPoveny Levell Income Income (low income) Income 1 $15,250 $25,400 $30 460 $40,650 $50,800 2 17,450 29,000 34,800 46,500 58,000 3 19600 32,650 39,180 52,300 65 300 4 21,800 36,300 43,560 58,100 72,600 5 23,550 39,200 47,040 62,750 78,400 6 25,300 42,100 50,520 67,400 84,200 7 27,050 45,000 54,000 72,050 90,000 8 28,800 47,900 57,480 76,700 95,800 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND CoMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUPISl WHICH IT SERVES, AS REQUIRED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, PLEASE INDICATE IF YOU ARE A MEMBER OF ANY OF THE FOLLOWING CATEGORIES: D Senior Citizen (62 or older) D Handicapped or Disabled D Person of Color D Receive Rental Housing Assistance D Lower Income (see table) D Member of the Local Homeless Coordinating Board Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council w!1l appoint a person or persons with expertise in construction and/or finance, a person receiviila rental assistance, and a person from the Local Homeless Coordinating Board. If you have expertise in construction or finance, please describe your experience and/or training. I have been a commercial lender for nea~y fIVe years, spending time in both the Iowa City and Cedar Rapids markets. Much of my time is spent in the commercial real estate and multi family arenas. I have banked several builders, a few which cater to moderate income families. I am very excited about our bank opening an office in Iowa City this coming year. My training consists of many internal banking classes from my current employer as well as my prior employer, US Bank; I am also a 2005 graduate of the Iowa Commercial Lending School which is an annual intense full week school, ,,' o g .....-- cr.... ::-?:C) c -':"_,.': c~ :;;TJ CJ1 ~) - HCDC Application June 2006 ~ -, I! page 4 of 8 ;;' ~~~ 5~' ~ --1 .',-, N V 'd 80V8'oN 6090-998-618 wm : II 900 G '9 G' I n r Page I of I Marian Karr From: Steve Crane [SCrane@bankerstrust.com] Sent: Tuesday, July 25, 200611:18 AM To: .City Council Subject: Iowa City Housing and Community Developmeht Commission Dear Council Members: I have applied for one of the two open positions on the Iowa City Housing and Community Development Commission. I am very willing to dedicate my time, energy, and financial knowledge for this great cause to assist low to moderate income families. I have lived in Iowa City for twelve years and my current employer, Bankers Trust, is opening an office in Iowa City next year. Our bank has always been committed in reaching out to the low to moderate income programs and have loaned money to organizations which specifically work with individuals who need affordable housing. Our efforts will continue when we move to Iowa City this coming year. I faxed in my application form today and can be reached on my cell phone at 319-331-9306 should you have any questions for me. Thank you for your time. Steve Crane Assistant Vice President Commercial Banking Bankers Trust Company, N.A 221 Third Avenue SE, Ste 150 Cedar Rapids, IA 52401 Telephone: 319-896-7798 Fax: 319-366-0509 This e-mail, including attachments, is covered by the Electronic Communications Privacy Act, 18 U.S.C. 2510-2521, is confidential, and may be legally privileged. If you are not the intended recipient, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. Please reply to the sender that you have received the message in error, and then please delete it. Thank you. This e-mail, including attachments, is covered by the Electronic Communications Privacy Act, 18 U.S.c. 2510-2521, is confidential, and may be legally privileged. If you are not the intended recipient, you are hereby notified that any retention, dissemination, distribution, or copying of this communication is strictly prohibited. Please, reply to the sender that you have received the message in error, and then please, delete the message. Thank You! 7/25/2006 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM I ~ I -~= -14' ,f~~;!:'t ~ _"'~ ---~ CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED .CONFIDENTIAL.. THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME Housing and Community Development Commisso TERM 3 years NAME Karyl Bohnsack HOME ADDRESS 3021 Wayne Avenue, Iowa City, IA Is your home address llisted above) within the corporate limits of Iowa City? [Z] Yes How long have you been a resident of Iowa City? 13 years ZIP 52240 DNo OCCUPATION Office Manager .'HONE NUMBER: HOME (319) 354-9593 EMPLOYER Latta, Harris, Hanon & Penningroth LLP BUSINESS (319) 358-0520 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I am an active member of the Iowa City Area Chamber of Commerce, serving as past president of the Ambassador Group and attend the Iowa City, Coralville and North Liberty Committee luncheons as often as possible. I am also a member of the Greater Iowa City Area Home Builders Association and am currently the chair of the Women's Counci~nd am lt1llember of the Home Builders Association of Iowa Board of Directors. 0 ;;? ~~C) " "- N 0' 'll -;- -, ,'-., ~.. - ., ~ ~:d. ;~ '-:-.:0- "- -'''' ,Tl -, ',-.J ~ [--T" " WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? w I have spoken with past and present members for the HCDC and read the Notice from the City Council for the appointment to the Commission, Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application June 2006 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING) ? Through my involvement with the Iowa City Area Chamber of Commerce and Home Builders Association, I have had the opportunity to hear the different views and facls from community members of Iowa City and across the state. This has helped me form opinions that serve the community that I live in and am raising my family in. I try to be as unbiased as possible while using common sense to think through situations. I feel this would be a good contribution to the Housing and Community Development Commission. I want to make a difference and contribute to the community that I live in. From what I have learned from other members of the HCDC, it is a very fulfilling committee to be a part of. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. )ther types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. ~ g None .,=:o )>=: , 2: r."'. N 0'" -Tl '" T1 r-1 ',.j IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [ZJYES DNO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES [Z] NO ,~) w lit has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application June 2006 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING I B 1 ~. ~1I3<IOi~M. :f~~~"!. ~...;~~ CITY OF IOWA CITY Name of City Board/Commission Housing and Community Development Commission Name Karyl Bohnsack Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). Dare 07/24/2006 List all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% Or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS None ".: ..---........--....-.. ~ .. , 0-' ""-..0 ( j..>--' r-- 'l ~~I - /r, 0' C ro '. - ~ h '. ~ =?: - , ,C ) '-..;,- - :;:--" , .. )> (..) \.D NOTE: A new form must be completed if the above information changes or an ownership interest acquir additional business. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. HCDC Application June 2006 Page 3 of 8 10/10 3911d SI&IIIH IIlllIl E0S08SE6tE vE:El 900~/9~/L0 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective March 8, 2006 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Level) Income Income (low income) Income 1 $15,250 $25,400 $30,460 $40,650 $50,800 2 17,450 29,000 34,800 46,500 58,000 3 19,600 32,650 39,180 52,300 65,300 4 21,800 36,300 43,560 58,100 72,600 5 23,550 39,200 47,040 62,750 78,400 6 25,300 42,100 50,520 67,400 84,200 7 27,050 45,000 54,000 72,050 90,000 8 28,800 47,900 57,480 76,700 95,800 ATTACHMENT TO APPLICATION FOR THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IN ORDER TO ENSURE THAT THE HOUSING AND COMMUNITY DEVELOPMENT COMMISSION IS REPRESENTATIVE OF THE COMMUNITY AND THE GROUP(S) WHICH IT SERVES, AS REQUIRED BY THE U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT, PLEASE INDICATE IF YOU ARE A MEMBER OF ANY OF THE FOLLOWING CATEGORIES: D Senior Citizen (62 or older) D Handicapped or Disabled D Person of Color D Receive Rental Housing Assistance D Lower Income (see table) D Member of the Local Homeless Coordinating Board Your response is voluntary, and you may wish instead to elaborate on or indicate areas in which you can make a special contribution to the Commission in another section of this form. When possible, Council will appoint a person or persons with expertise in construction and/or finance, a person receiving rental assistance, and a person from the Local Homeless Coordinating Board. If you have expertise in construction or finance, please describe your experience and/or training. I am the office manager of Latta. Harris, Hanon & Penningroth, L.L.P. a Certified Public Accounting and Consulting firm in Iowa City. I am not an accountant, but in the last'six years of employment I have gained finance experience through the preparation of income tax returns and financial statements for various locai businesses, some of which are contractors and developers. My training has come from the CPAs and LPAs within the finm. o ~~0 .'::::;:, .-.~ .... c~: ..-.",--.- c" HCDC Application June 2006 0") , -_. page 4 of 8 2::.:,:.' :$: ~ ::'2 , ... -':,~.I :,",J - (..j W ~ NOTICE THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING BOARD: BOARD OF liBRARY TRUSTEES One Vacancy - Unexpired Term Ending July 1, 2007 The Board of Library Trustees is a semi-autonomous body of nine persons empowered by State law to plan, direct, and control ali affairs of the Public Library. This includes determining long-range goals of Library service, adopting written policies to govern operation of the Library, and employing a competent staff to help plan and implement the Board's service goals. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Library Board meets the fourth Thursday of each month at 5:00 p.m. Applications must be received by 5:00 p.m., Wednesday, July 26, 2006. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Board of Library Trustees should be directed to Susan Craig, Library Director at 356-5200. 6/14/2006 Board or Commission: ICPL Board of Trustees ATTENDANCE RECORD CALENDAR YEAR 2006 Meetlnc _ Date Name I ~:::" 1/26/06 2/23/06 3/30/06 4/27/06 5/25/06 6/22/06 7/27/06 8/24/06 9/28/06 10/26/06 11/16/06 12/28/06 Thomas Dean 7/01/09 X X OlE X X X Bill Karf 7/01/09 X X X X X X Tom Martin 6/30/11 X X X X OlE X Unzee McCray 7/01/09 X OlE X X X X Meredith 6/30/11 X X X OlE X OlE Rich-Channel Pat Schnack 7/01/07 X X OlE OlE X OlE Leon Spies 6/30/11 X X X OlE X X Tom Suter 7/01/07 0 0 0 0 0 res David 7/01/07 OlE X X X X X YanDusseldorn KEY: X = Present o = Absent OlE = Absent/Excused NM '" No meefing --~._-~--~----------------",.._---- Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and. Commissions. This includes: spouse, child, mother, father, mother- in-law, father- in-law, brother, sister, brother- in- law, sister- in-law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 5 Females: 3 Council Announcement Date: June 13, 2006 Application Deadline: July 26, 2006 Council Appointment Date: August 1, 2006 BOARD OF LIBRARY TRUSTEES One vacancy - Unexpired Term Ending July 1, 2007 Tom Suter resigned John Kenyon [8] 1112 Church St Mary New [8] 212 Ferson Ave Thomas Vakulskas [8] 2033 Little Creek Ln Michael Cohen [8] 24 Evergreen PI 00 Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM I ~ j ~""::'_IiO~ :f~W~'"!.:t "'-... ......'- ........ ... CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME Public Librarv Board of Trustees TERM: partial Youth Advisory Commission, Age on the date of filing: 0 Age 15 to 17 (or) 0 Age 18 to 21 Signature of parent/guardian if Age 15 to 17: o ,.." = = ~ ~.> r..... ,~.~-::- < <..... r- I <.oJ 11 'AME John Kenyon ,...., :::.~' r- HOME ADDRESS 1112 Church St., Iowa City, IA " " ~2245: [l] Ye~ / '~o Q') ;'TJ t-, \. j Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? 16 years OCCUPATION Newspaper editor EMPLOYER Corridor Business Journal PHONE NUMBER: HOME 351-6191 BUSINESS 335-4860 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I am a long-time user and supporter of the Iowa City Public Library with knowledge of its workings and structure. I also know several librarians (not at this library) and talk with them frequently about challenges and changes that impact such institutions. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application June 2006 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I am acquainted with some members of the board and have discussed its duties with at least one member. I have -tudied the board's agendas and minutes to get a feel for the types of business it conducts. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? As a long-time library user, I am very familiar with its mission, goals and possibilities. I feel I can offer valuable input and ideas both as an individual and as a member of the business community. I pay particular attention to technology as it applies to communication, and can offer input about how that might affect what the library can offer. I also have strong communication skills that can help within the board and without. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. , particular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Se<;1jj:>n 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. 0 g _ c...-.. "- <- None. )> 1.:-:: Il ,- r, I W . - :T] -0 . , IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [{] Yes ~6~ r:y p a DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? 0 Yes [{] No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application June 2006 Page 2 of7 JUL-04-2006 rUE 12:26 AM --, _.- ~_. --- - FAX NO. p, 01 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING I! 1 =~=__s4'... :f~W~'"t. -..;;;:.....~..=J~ ...,...... CITY OF IOWA CITY Name of City Board/Commission Library Board of Trustees Date 06/30/2006 Name John Kenyon Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions. a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS None. r; = = ~O , .~~~ ~.! , -n - -) ,- r-- ::-jr...., w ~-<, -0 Iii ,---;- ,-~ r.n) ::.U ~ '_J ~ -;- - ~ .. -J . NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. Applicant Signature JL r 4 Signature of parent/guardian if Age 15 to 17: Address 1112 ChurCh St., Iowa City, IA Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application June 2006 Page 3 of 7 Page I of I Marian Karr From: John Kenyon [kenyon8@yahoo.coml Sent: Friday, July 07, 20063:08 PM To: .City Council Subject: Library Board of Trustees application Dear Council Members: I have submitted an application for the open seat on the Public Library Board of Trustees. Per a suggestion in the application materials, I am contacting you to alert you to my application and to let you know that if you want to discuss the position with me prior to making your selection, I would be happy to do so. I can be reached during the day at 335-4860, and in the evening at 351-6191. I also can be reached at any time via e-mail atkenyon8@yahoo.com. Thank you, John Kenyon Do you Yahoo!? Get on board. You're invited to try the new Yahoo! Mail Beta. 7/7/2006 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION "",PPLlCATION FORM I ~ 1 ~~~~'t ""=-... _JIII''- ....~ CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME I CPL 'B1l(I..l("'d.. Df Tn....6~ TERM: ~ Youth Advisory Commission, Age on the date offiling:D Age 15 to 17 (or) 0 Age 18 to 21 Signature of parent/guardian if Age 15 to 17: . .I\ME -^"IW~ "B. NbtJ . HOME ADDRESS 2..12. f"~~cr'\'"\ A,,(... ZIP S 2.%.4-(. Is your home address (listed above) within the corporate limits of Iowa City? ' [EI Y~ CJ ~o How long have you been a resident of Iowa City? ~'2- '1t..oK~ ~ ._~ F I I OCCUPATION (t,. -h i"t..~ EMPLOYER --j ( . ,- PHONE NUMBER: HOME ~Sl- ~ BUSINESS :-;t=; ;;; '=D ~--", ,---,,' EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS EDSITI@: ~ ~ ~t~ ~~ I'f'Mt ~u-tA.L t~ h. fru.. lc..~\.. 'A.-<~. ~~~l>.A.L. ~ CLl~ ~ k.v 1\u. ~l..:ht"W'\ ~~~~t ~ 1\u. Llbto.Al..t &1Lt. ~4..q ... 1J..4A. '&.&fu- ::r JU..~ q".. 'tP^- o,f(b I ":r W-o..o ~ ~ i\u. tJ~l~ 'f ~hJ"" ~ ~~'W.~. I.~ ~:f- (1t.~~ (lA CU.~~ ~ ~ -h ~ (p1A-:S>lJ...a......t. (j Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application November 2005 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? d ~~~ ~~ -:p.u.L1-~W l>e~4((4..-t.1J::1 fY"1 ~k.. 1,U'\.-n... "flu.. 3I\U.~' ~ ~kl,;c..!.lt..~ f>,4JLd... /J WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? ~~~ ~!-..od.~ ~?:-}; r~\-i.~ ~~~~.~~:-~~~ ltWt. ~ ~~eL~L~+S. J1Ltc..ct..\: ~_~, ~ k-t..W. ilu. ~ i1> ~... li~ ~~~ ~ ::1~!~J~h:~,U-- aJJ. I 'd W1I-1c.-lcl.. ~ 11u. ~ ~ CMA. IlL LvH.O 4- '6W. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests,including financial interests and your duties to an employer. ..1 particular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. . Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). '" - = If you are uncertain whether a potential conflict of interest exists or have questions ~~t S~tion 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. ):; _~ 2: c) _IC-' :-<1...:.... 1-.- " S2;; -u :l'.: iTi :-, \.....j IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [kjYes No ~ DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYes [gNo (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application November 2005 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING I ~ i =~:'....14~ :!:~W~"'!. "'-.... .~""'- ___ .. 1 CITY OF IOWA CITY Name of City DL ~ '" Ti ' Board/Commission IC~ ,nv..t .&-'~~ Name (\Wy. r-!~ Date~/lIlt>b Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isatlached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 1.5 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS / 11~'-'" ", $- = "" .D- c;:;: (.~. - ..~ 0" ;.-, ;--<...~ R~j ::it '. -s/' ~. .. ~ NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additiona~USiness. I. \ Applicant Signature . ~ Signature of parent/guardian if Age to 17: Address '-,'2.- '3"~ ().o...L.. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application November 2005 Page 3 of 7 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION .. PPLlCATION FORM I ~ I f~~~1lt -.,;;;;... "'IIIII~ .....,.. ... CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME Library Board of Trustees TERM: Julv 1. 2007 Youth Advisory Commission, Age on the date of filing:D Age 15 to 17 (or) 0 Age 18 to 21 Signature of parenVguardian if Age 15 to 17: NAME Thomas A Vakulskas HOME ADDRESS 2033 Little Creek Lane Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? 7 years ZIP 52246 [Z] Yes 0 No OCCUPATION Retired EMPLOYER PHONE NUMBER: HOME (319) 354-7241 BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: I served as a Trustee for the Sioux City Public Library for three years o ~0 t-...; .~ c'::. 0.... -" .", '. ~. So, r-- r-.:> -rl , -.....- :,~.., If,' -n C):;;.::_~ ::;;:. /, " -r1 "---, .J <- '" en Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application June 2006 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? It is an advisory board only. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? With my experience as a trustee with the Sioux City Library and my almost daily visits to the Iowa City Public Library, I can share my experiences to help the library continue to grow. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. ;>articular, if you are applying to be a member of a board or commission which makes recommendations tothe \...Ity Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions a~_ut Se<<tism 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. 9 ~ i;:-.:: ,.-~ ,. ,- r- N ...-- -7< I, "','-1 " :"J.:._ ;- -:c~ :. f~( IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? III Yes [jf~ ~ DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? [J'i?es III No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application June 2006 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING I ~ I -"...= -14' ~~~~-r -..;:.... ...11II.'- ....... l CITY OF IOWA CITY Name of City Board/Commission Library Board of Trustees Date 07/24/2005 Name Thomas A Vakulskas Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS Vakulskas Law Firm PC 1721 Jackson Sioux City, IA51105 ~. Q g c'.,, ",0:<;-" <... .,~ c: '---'. "'<~ N _.' I -. :::;i( - .::- --' '. ../ ;'--""--' .- 'F--- [I; ""D -~ <^ ~ .J> .,,- ;; NOTE: A new form must be completed if the above information changes or an ownership interestis ."'";,..,;" '" ~~ Applicant Signature ~ ~ Signature of parentlg rdian if Age 15 to 17: Address 2033 Little Creek Lane Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application June 2006 Page 3 of 7 JUL-26-2006 10:54 UI PATHOLOGY 319 384 9613 P.02 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION J.... >PLlCATION FORM -~.!-~. ;t~4:!1'"1. -;;... ....I~ ......~ CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. L ...-:-::--- ADVISORY BOARD/COMMISSION NAME ,!Sf? r1-D or: lfivs./a} TERM: 21136-1 Youth Advisory Commission, Age on the date offiling:D Age 15 to 17 (or) Signature of parenVguardian if Age 15 to 17: D~ 18t~1 -() ,- b --: c: -- ~-') f'-- Po '" ~;-'< :.=:j (--. --< 11 '" "lE IiJ i:; ::r;:.. , I. \---' H, 0/1#'l tr HOME ADDRESS 1- ~ eV6rl4ill!(:~ 7L I. C . Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? 16 y;z.s. OCCUPATION ~'1!' ~//hJ EMPLOYER UN/V. Or /tt-JA- PHONE NUMBER: HOME '3,'3.'::;.- fs>,~ '3 BUSINESS ~fS"l( 't6~7 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: , BottflD H64s7& or S6.i:;n/f1" rJlIIJ. yn..Frr 7l4f"i:'1.Sto#lt1.- !:oclltTlt;').. . Vfl~1'Z-~b 1 M1fZe"c,tf7'e- 11le- \j1f'we Or R1e ~"l1'l-tl<.., of "fI1l;"" lAti7./H1 If1. WE-U ~ it 8>r...'1/'17 11- ~OMI'f,j,J,"i) ~~uflU ~ 'F/TM~g~ 'f1tfYer Y1t?3>F ~lE"1'1qv'F \/f.E- e1=- /?(€'" . 'ff1N~ 1Jc!C--w tt (r;N1 j:.SViOt- /hifN''HA1''~ #J~:P> o:..:-~ </,", 0 <::.... .. ZI?' .f"u..~{" ~Yes 0 No '-../ Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail '0 answer all the questions, Council may not consider your application. General Application June 2006 Page 1 of7 JUL-26-2006 10:54 UI PATHOLOGY 319 384 9613 P.03 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I #tve +tlfb 0>N1It'l:t ~ 1fh r~ CIJ/llld'JoJ 7' I~ -' bJb 'I1.IN€ 'tr;-..Jtft?l.J~ S..t1G- of rrr;: 11~{6SI ff'fo/oTi€"'. 1M ~"'llolJ) I 'U/1.J€ ., - l1k't) "'~~"'ft'1 ~,19-1 ~'Uf'~ ntu02. C 1 Cpt... ~"""'~ o'fTl C? r1~If1tGf!.J WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? , U 1I'b<..';lS}/t)i> 'tHe /lor..e 01= J4- ~fie~ It! <l{t:fIl*/~ 1'2ol-e "ffj ~ '~.f€ Pt)\j Cf"1 f./;5rnJs"51t.li7~ "11kC1tFfi 11fE ;H'/"i?r'f'J~€ f'fF ?*/~/ftl'2jrf ,0 1k- L.1~ 7b COMHiI /Y-fE rlea;s>~<J'';'1f" 1 ~7R11 , I ~~ 'Se'7.fl:N~ JA'-t VflIVaz-~/'7 ~?-<:;Z.~te- (NIl.-(... ,"3: fhJ rtr..S€I It> 'N11F ~~j) 0 ~} *0 e >:>~.; 1"'-- . , , -n no ="{c:: N 0-' ,.- \11 ~ n; ~ 1 1 POTENTIAL CONFLICTS OF INTEREST;.-- ::;.: :Jl: '_./ 97": (5 Please identify any potential conflicts between membership on the advisory board ~ yow::..,personal interests,including financial interests and your duties to an employer. 0' In t Iicular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation' includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. I ff~~ ~~o.u I IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? rv1 Yes D No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD O~OMMISSION? DYes MNo (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same tlmJft\ . Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail , answer all the questions, Council may not consider your application: General Application June 2006 Page 2 of7 JUL-26-2006 10:54 UI PATHOLOGY 319 384 9613 P.04 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING l! J -::. ~iQ>... !~W!:'"I. -.;:::... --..,- ...,..- CITY OF IOWA CITY Name of City L ~ ~ Board/Commission 1!:Jl1ff'{, ~) r; JPv$.Je~ Name 'r1INt~ ~. ~tiJ Date Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 Isattached (see page 6). List all businesses in which you oryour spouse/domestic partner, or parent if applicant isAga 15 to 17, have an ownership interest (for example, sola proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS r At..r,. ,-> 0 c o~ .2: - ) S oil "1> _.~.; r) . 1'.) \ .-- -~-\ ~, ; ,-r ~"'/ ..... " ~ -:;:..--:::::c '-- . :;;:/' '-;': Y (J'\ NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. ;J Applicant Signature Vh.ctd rl:::::::.. Signature of parent/guardian if Age 15 to 17: Address ')..; 0iC.-1lI.,Utf/-J 7'L- I.e... ~1.:Vt(' Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail . answer all the questions, Council may not consider your application. General Application June 2006 Page 3 of 7