The URL can be used to link to this page

Home My WebLink About1993-04-27 Appointment - -,;r V" ~ "......... .,,-.-- I - .. ~'-~-""'-r .,.,. - - "~;-' ,:ti..> ~'ffi" <I: '-'" ' ;()' "", ';"," ,,' ,:_~j," ':<::riJ~~ ',~~, : ,::,:,-::,>,~''];'' : , ,:"~.' ", "': ~,: ~o) 1Cir. OHice 01 Minority Sludent Development April 7, 1993 The Honorable Darrel G. Courtney Mayor City of Iowa City 410 East Washington Street Iowa City, IA 52240 Dear Mr. Courtney: It is with regret dtat I must resign as a member of the Board of Appeals for the City. I have enjoyed my short tenure on the Board, but because of pressing professional and personal scheduling and commitments, I must resign. I thank you for the chance to serve the City of Iowa City. Sincerely, U~Qt~ ~ Velma Tribble Director VT/nd cc: Robert Carlson, Chainnan Department of Housing and Inspection Services Ron Boose, Secretary to the Board 2201 North Dodge Street, P,O, Box 166 Iowa City, Iowa 52243 1319) 339.3077 1#1 II" '~.'. 1IIiii":,1, -:.,.;.... :,'1 J ,', ',",' '",' :"', " t 'I" -~' ,'-, " "1" .. ,'-'- .," " ," " .' ,',"(;,0;, "":1 ,'" :',,' , --,' ":, " " . '\, .',. '", ", ","" .,".,',......,. ',.~r',..',~.~~.r:.- l....li.:" .::._,....(.:.'.' ,': l !:!Q!!QS THE CllY COUNCIL OF IOWA CllY IS CONSIDERING AN APPOINTMENT TO THE FOLLOWING COMMISSION: RIVERFRONT & NATURAL AREAS COMMISSION One vacancy. Unexpired term April 27, 1993" December 1, 1994 It is the duty of members of the Rivertront end Natural Areas Commission to Investigate, study, review and analyze the rivertront needs and to meet such needs within the City of Iowa City; to Investigate and determine what rulee and regulations are needed end what policy should be established relallve to the rlvertrontln Iowa City; to study, Investigate and make recom. mendations relating to clearing, planning and construction of riverbank areas for providing green areas and floodplains along the rivertront. The Rlvertront and Natural Areas Commission meets the third Wednesday of each month at 5:30 p.m. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. This appointment will be made at the April 27, 1993, meeting of the City Council at 7:30 p,m. In the Council Chambers, Persons Inlerested In being considered for this posnlon should contact the City Clerk at the Civic Center, 410 E. Washington Street. Application forms are available from the Clerk's office upon request. i'i' ---~.... I ".. ....-- ".-.-- ._---.---.-~ ~',,: if":"', (!;;:: ,. ',;;:;,,;>:;, i; ,,;: .,:,'" "<,::'~,,', ,',,' \ "~" - \ t., .\ I :~ ,\ (~<: '. ';;~~"> J',~~': '. 'j :-\'. ,\ ":"'. ',,' '-;, . April 27, 1993 HALES: 5 FEHALES: 5 RIVERFRONT & NATURAl ARF.AS COHlIISSION - One vacancy - Unexpired term - April 27, 1993 - December I, 1994 Judy Pfohl 2229 Aber Avenue Jim Pugh 2263 Riverside Drive vllr .... - . ~.....- ~ ",~,:,,,,,'.',,, ::~..:' ,,'....-:: ,',' ,,' '~"::':"';"~":' " ' " ,,' .(;.,1 1,2J" ',' ", , ,,'" ~' ~ :', . '; " \ ,'j, ':. '.\ . '. . I. ' - ~. ' ",' ., '.' I . ,f" ,m.., ,1'7, "C"", " '" ' " , .\",.",~,'.. \~l' ,~., ,.\', " ,.' ,'~ . CITY OF IOWA CITY . AOVISORY BOARD/COMMISSION APPLICATION FORM Individuals serving on30ards/COlll1lissions play an ilTllortant role in advising the Council on matters of interest to our cOlll11unity and its future. Applicants IIlJst reside in Iowa City. The City Counc il announc2d Adv isory Board/COlll11is s ion vacancf es 90 days prior to the date the appointment will be made. This period provides for a 30-day advertising period and a 60-day training period for new members. The training period allows new members to become fami! iar with the responsibilities and duties of the advisory board/COlll11ission before becoming a full votin'J member. After a vacancy has been announced and the 30-day advertising period has expired, the Council reviews all applications during the informal w'ork session. The appointment is aonounced at the next formal Council meeting. Appointees serve as unpaid volunteers. Council prefers that all applications must be submitted to the City Clerk no later than one week prior to the a,1nounced appointment dates. '.PLEASE USE A BLACK INK PEN. THIS APPLICATION IS A PUBLIC OOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC. THIS APPLICATiON WILL BE CONSIDERED FOR 3 MONTHS ONLY AND AUTOflATICALLY CONSIDE~ED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COftHSSION NAME R,vu.fr"",+ ,.1 tJ.,-f,.r.1 Av.~~ TERM Ar,;/17 ~r.,.t"'t.i NAME , J... d~ \ HOME ADDRESS 27.2.'i A-~ Awl Is your home address (listed above) within the corporate limits of Iowa City? YIt ~ OCCUPATION S-h-d." t EMPLOYER PHONE NUMBER: HOME 31J/-/(,!1{- BUSINESS EXPERIENCE AND lOR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~cTiv~,'" r,;'MC.{ Nt,' H."h.,d ,'.-/("s+ ...;-n; ~,w.,iJ f"r/:.. !h..~ 8I,I'!l d<?,,~ 4.d 1/'" ' '" eJ Sc,..,(,! QctG~. :r.Ie'fJ'kJ I~ w;/j/" .. d Utm -h Arks .( r..r~, I WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? a.d ,<0".1,,,, /,'"1f P'f/<'S A.d RUd.f,,,, ooJ 11.,0",'-1 -;." ""v,'& MJwi Iff J tfht.fJ luJlKr ctulw kI/ff t!"II, f'lIlftrAt it I I WHAT CONTRIBUTIONS DO YOU .FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR a I z c,,, 1.1 k .. 4'>> d 4 .ord t'le", 't4', I -.. ,.., \.0 '" SpeCific attention should be directed to possible conflict of inteiist;jsa~!ined in Chapters 362.6, 403A.22 of the Code of Iowa. Shou ld you be uncert:a:ln: whether,.-.or not a potential conflict of interest exists, contact the Legal Departme~..:, Wl'll ,too have a confl ict of interest? _YES --L..NO :_),,; :?: ,~ --., -- _'" -_M. If you are not selected, do you want to be notified? ~YES ;~!;NO ~ ~j -.,J Do you currently serve on another Iowa City Board or COlll11ission? _YES .1L NO It has been Council policy not to permit an individual to serve on two Boards or Commis- sions at the same time. June 19B8 'Sift , - -:' v . ... --,.......... V-'- . .. ..-----.....~- -.-~ ,...... - - '''-r- .-. ,..-- ... ~T- ...- ~, .:' '-,," " ~ .,.~;~, I' ,""""I ".'. ,',:: "'~', .','.', I.,.,.::' ,.:: t, , 'tEl' '~'-" 'I,j, '8, , ' " , " " , " ~", , '\ '. "t~.: : . '. ';'. '. I' ',: ,~r, ,. , , , . ." , ~. .,' \\;.' .~, ' '.' . ...., .. .' . .. I . ,"j. ",,,),, '---,,' , ., '....., (' ",:W I' .,', , ., ,.:. ' . ,I,",~ " . ' _ . CITY OF 10llA C lTY . ADVISORY BOARD/CDMM[SSION APPLICATION FORM Individuals serving on Boards/Coomissions play an i~ortant role in advising the Council on matters of interest to our conmunity and its future. Applicants IIlJst reside in Iowa City. The City Council announced Advisory Board/Conmiss ion vacanc les 90 days prior to the date the appointment will be made. This period provides for a 30'day advertising periOd and a 50-day training period for new members. The training period allows new members to become famil i ar wi th the respons ib ilit i es and dut i es of the adv i sory board/ conmi s s i on before becoming a full voting member. A fter a vacancy has been announced and the 30-day advert i sing per i od has expi red, the Council reviews all applications during the informal w'ork session. The appointment is announced at the next formal Council meeting. Appointees serve as unpaid volunteers. Council prefers that all applications must be submitted to the City Clerk no later than one week prior to the announced appointment dates. PLEASE USE A BLACK INK PEN. THIS APPLICATION [S A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED ANO DISTRIBUTED FOR THE PUBLIC. THIS APPLICATION WILL BE CONSIDERED FOR 3 MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COIiHSS[ON NAME~-,t-~t1~ TERM /.~ NAME ~~ p~ ~ADDRESS;2b3 ~~9~ Is y~ home addre~(listed above) within the corporate limits ~f Iowa City? ~ OCCUPATION &"AV-1 - ~ au_ "'-~ EMPLOYER dL ' I' PHONE NUMBER: HOME .3 J 3' ~ ;Z t r 6 BUSINESS -,pi 33 J>' -7- 6;z.-6 EXP IENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:, 0. . ~p^, /7~, ~.Aj~.ii,1.C. C~~~~-;~...2:-e, WHAT IS ,6 PRESEHT ."'WLEDGE " T>lS ADWI"~Y oo.~; ,,:::::::::;-::;..~c. ~hU4<r~) '2<;r;e;6 ~ t:!..~' Jjj;) />f/J. . ,(P.. ~~~:r;~~[~~~;O)YO~;t~-'~-;;o THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)?' I' Specific attention should be directed to possible conflict of interest ~ defined in Chapters 362.6, 403A.22 of the Code of Iowa. Should you be uncertaJn wh€jjner or no.t a potential conflict of interest exis,t~ contact the Legal Department:F,\I~ YO.II] have..a conflict of interest? YES -e:...NO ~::: i\) '""" - .~.;'\) '..,,:::a [f you are not selected, do you want to be notified? ~YES ;Nit ~ ~:; ,00 you currently serve on another Iowa City Board or Conmission? ;::;f~~ ,i/NO . ~. w ,',) It has been Council policy not to permit anry idiv dual to serve on two Boards or Conmis- sions at the same time. ~ ,. June 1988 . ~ 021/ Ie:; f'.J -- 81/' -~, .,..............,.......... .".....--- I I , ! I , , , I I I j i I I I I I I I I I ! i , . "'-'-'--"-~---"""'--r--,.--y- '-r-- .-. .,.~ . ...,.- ':' , t4.," ',..~:"';,' :,:';:'1 ' .; '8' "',": '. "'" ',: ::" .', . J, ,~." I .' I.:, ~....~ ... ~ , :'.. .'" '.' "'" ::' "':"~/ :,:....~,.: ,1.1.,.;.:,,: ;~'\-:: .~. ',' ',' \~ t!QIlC.& THE CITY COUNCil OF IOWA CITY IS CONSIOERING AN AP. POINTMENT TO THE FOllOWiNG COMMISSION: BROAOBANO TELECOMMUNICATIONS COMMISSIOI{ One vacancy. Unexpired term April 27, 1993 - March 13, 1994 The person appointed to the BTC at this time will take part in the renegotiations of the cable TV franchise, The duties of the Broadband Telecommunications Com. mission include serving as a review board to resoive disputes between any subscriber or potential subscriber and the cable. vision company; reviewing and auditing reports by the cable- vision company to the City as required by the Cable Televi, sion Ordinance; working with the public, the media. the City, and the cablevislon company for the purpose of making recommendations on various Issues; engaging in other ac- tivities pursuant to the effective monitoring and evaluation of the CATV system in the City. The BTC meets the third Wednesday of each month at 5: 15 p.m. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City, This appointment wlli be made at the April 27, 1993, meeting of the City Council at 7:30 p.m. in the Council Chambers. Persons Interested in being considered for this position should contact the City Clerk at the Civic Center, 410 E. Washington Street. Application forms are available from the Clerk's office u~on request, ! i I i , I I , , i I I I 8'19 , , , ,; ',' .;.0; ", ~- . ':,"-/" ;'{Z:" ""',',:.-,, '.' ,,.' :', ':, :': i' ':" ::,:! ',' ,',"~c i"'".-j ''',: - ','", ,':,' ", ',,:," , fl.. " "\ " ,L" _" , " ", , . '" ,......, . ....~',. .,'-. '\ I /. '.' I " i , MALE: 4 I , FEHALES: 0 I , I April 27, 1993 I , : BROADBAND TELECO!~ICATIONS CO~IISSION - One vacancy - Unexpired term April 27, 1993 - Harch 13, 1994 Paul G. Ipsen 925 DeForest Street Kevin B. Hoyland 317 Court Street Place Joyce Patton 857 Normandy Drive , " i ! I. ! I , , , I I I I , I I I I I , , i , i"~ I ... - - . . I' "'1) ',. >..,;. . ,- ,", ," ,:", ,,';.', ,', , "f ' '~> '" tj'" I >, ,', ' ,> \ ~\i' ',' ,~~.' I.: \."..!~/. ..J ), ,.',:,,~, '> " ,\" :' ,.:;': , '" ,\1 ~, ' t ,I.' I' . .. ", ,,' . ::: :,' ........:',':,.1 ,v~'I":'" .~';', . . ~ I .)' ',~.~ ~ , ",' , ,,'. ,~: ....' - CITY OF IOWA CITY - BROAD8A1ID T~IY0'!!1UNICATIONS COl1HISSIOtl APPLlCATIOtl FORN Individuals serving on Boards/Colll1lissions play an important role in advising the Council on matters of interest ,to our cOlll1lUnity and its future. Applicants must reside in Iowa City. . , , The City Council ::dpnOUfl~nd Mrisor.r Board/Colll1lission vacancies 90 days prior to the date the appointment 'W'i'1'l"l1el.made /: fHis period provides for a 30-day advertising period and a 60-day training period fouew members. The training period allows new members to becOOle famil i ar with I,th~' r.~sp'Qn,S;i,b,1l fti es and dut i es of the advi sory board/ cOlll1li ss ion before becoming a fu ll'''vot-i'ng' member,,, After a vacancy has been announced and the 30-day advertising period has expired, the Council reviews all applications during the informal work session, The appointment is announced at the next formal Council meeting. Appointees serve as unpaid volunteers. Council prefers that all applications must be submitted to the City Clerk no later than one week prior to the announced appointment dates. PLEASE USE A BLACK INK PEN. THIS APPLICATION IS A PUBLIC DOCUHENT AND AS SUCH CAN BE REPRODUCED AND OISTRIBUTEO FOR THE PUBLIC. THIS APPLICATION HILL BE COtjSIDERED FOR 3 I~OIHHS OllLY ANO AUTOI.IATlCALLY CONSIOERED FOR AtIY VACANCY DURING THAT TH1E. ADVISORY BOARD/CDt.nmSION IJAHE iii, )1' TERfI/U,IIl" I h L,~'..h NAI~E 0 ee 1\ HO'~E ADDRESS ~J Is your home address (listed above) within the corporate limits of Iowa City? ~~ OCCUPATION ,( ~ EflPLOYER PHONE NUflBER: HDt~E BUSINESS - EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS PDSlTIOII: Prell'lew e.X)'fI"'-"U h ~. c.. , .; yt.tUS, WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? rtt'jt~+ lGU.~ Ctfo'l w~ r:U. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? P,,,",OlU UIIII~"U.U ill\-kru.t "1\ & e.,r,C/ ~ U_ f~___.. ," .' L \,' ~o,,~ I ,,,-Iuut '" 'Me. r(JY'.-t""l.IiA.~I.U". Specific attention should be directed to possible conflict of interest as defined in Chapters 362.6, 403A.22 of the Code of 10V/a. ' Should you be uncertain whether or not a potential conflict of interest exists, contact the Legal Department. Will you have a conflict of interest? _____yES ~NO If you are not selected, do you \~ant to be notified? LYES _____NO Do you currently serve on another Iowa City Board or COlll1lission? _____yES ~ NO It has been Counc 11 po Ii cy not to permit an i ndi vi dua 1 to serve on two Boards or COlll1lis- sions at the same time. June 1988 ~"9 .-- .. " : 'ffi~' ,,~...<,: :7" ' , '-,' ,", " "", ,:' '," ,:,"-': ' . : , " I., I"" " " . ... ' " '," :,.':, !'" ," I': ' ,: .,' ~ '." , 'I '. ;" I , " ' "; . ,~ " ,;~' ".,~ . 0,1; I',' "I '" '... ", STATEMENT OF INTEREST A "yes" answer to any of the following questions will not necessarily exclude you from consideration for appointment to the Iowa City Broadband TelecOlTlllunications COITIIlission. However, the information will assist our Legal Department in determining whether or not there may exist a conflict of interest which would preclude your further consideration. Are you or is any member of your imnediate family or anyone dependent upon you: a. An employee of or a stockholder in either Heritage Comnunica- tions, Inc., or a subsidiary or limited partnership(s) (including Cablevision Associates VII) I the general partner of which is or is controlled by any of the above? Yes No X b. An employee of or a stockholder in any radio or television station or news publication operating in Iowa City or serving the Iowa City area or of any parent company or subsidiary thereof, or in any other manner affil iated with any of the above? Yes No )t c. An emp 1 oyee, stockholder, partner, or propri etor of any corporation or business which has or is likely to have a significant contract or business connection with either Heritage Comnunications, Inc., or a subsidiary or limited partnership(s) (including Cablevision Associates VII), the genera 1 partner of whi ch is or is contro lled by any of the abov.e? I No )4 Yes If you have answer "yes" to any of the above questions, please include a complete explanation using additional paper if necessary. f'lq ", :" ..., ,', :...., -:,~ ,," ',@',"'"',i,,.',';:,'..," ,'" [/''''B ",,,,,I '" '. "'" ,.. ,', "'-',:',1, ""',,,'m"""',t~.:"':'l "",,. '. ~/" ',,'...... \, " I \~ ."",1 ',1., ~_ I , . :,' . I' " . f .>-' ~. r' , I _ . CITY OF IOWA CITY . AOVISORY BOARD/COMMISSION APPLICATION FORM I Individuals serving on Boards/COi1lIIissions play an il1llortant role in advising the Counc 11 on mat ters of in teres t to our comnun i ty and its future. App 1 icants I1IJS t res i de in Iowa City. The City Council announced Advisory Board/Comnission vacancies 90 days prior to the date the appointment will be made. This period provides for a 30-day advertising period and a 60-day training period for new members. The training period allows new members to become familiar with the responsibilities and duties of the advisory board/collrnission before becoming a full voting member. After a vacancy has been announced and the 30-day advertising period has expired, the Council reviews all applications during the informal w-ork session. The appointment is' announced at the next formal Council meeting. Appointees serve as unpaid volunteers. Council prefers that all applications must be submitted to the City Clerk no later than one week prior to the announced appointment dates. PLEASE USE A BLACK INK PEN. THIS APPLICATION [S A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND D[STRIBUTED FOR THE PUBLIC. THIS APPLICATION WILL BE CONSIOERED FOR 3 MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY OURING THAT TIME. ADVISORY BOARD/COflHSS[ON ~IAME ~ T C TERM NAME k'P.I)/~ (3 {i()lla'1~ HOME ADORESS ]/: ('Ot,),r--" S? f.//]r-€ Is your home address (listed above) within the corporate limits of Iowa City? ~~,) OCCUPATION GOOlD VIS;"'!} fecL EMPLOYER Ire 5.0' PHONE NUMBER: HOME '38! q /1/ BUSINESS ~'? '9 G 'j(,(-J- EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: CI S C1.,ib 7@.rfrf,r)r....LCc,)[Jor" 1 ~<IJ/-:" or: \'!1" +'~, !rI::~ ';0 It" ~6' ~:0,-~P,; Q";;;;J I~C;::, ;' ~'!1-f'''' Is Q(I~ ,'7f JAr/'OUS h.(url.r Ii-, t;Y\.)1n/J1-, n~ v f ),P,V'<'. i?iJ't:J ro LI C d )- II' '0 I.? :..(P , WHAT IS YOUR PRESENT KNOWLEDG OF THIS ADVISORY BOARD? -T J, a tN a /10? 1(("j SQt/{Jn:;/ n-.,o.p")~dS It--rC-J,ll:'tJd (<1/ .(Jr'hJ f(;:::.qt.- WHAT CONTRIBUTIONS DO YOU .FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (DR STATE REASON FOR APPLYING)? -r; /'1IA LH.. I ~7v-{) ~/ f.';" ('(1 AI,? Mlh"-. (/(17) 1:24,,, J1"'~7 {,....,/a d' ;, eei 1- T)' i'\ I.,,: III (J.( f Tl.9 (I f..... "'~ '&:f/I'J..'J ! A,' './?c ~ If q i../ "r~", Specific attention should be directed 0 possible conflict of intmst as defined in Chapters 362.6, 403A.22 of the Code of Iowa. Shou ld you be uncertain, whetner or not a potential conflict of interest exists, contact the Legal Department'.:wm you.;have a conflict of interest? _YES .:::1;:NO,:" I~ ., ... .... If you are not selected, do you want to be notified? dc:-YES ---t!.~~ ~ ':: '0 you currently serve on another Iowa City Board or Comnission? -:YE~ .-t NO It has been Council policy not to permit an individual to serve on two Boards or Commis- s ions at the same time. June 1988 ''I' ...' '"., ~.. \_ ,,".. , ..,'~ .,'" - 'l~""" ': 'I' \ ~ , , ;,'."'. l':. ',','r' ... '., , ",,' ,',"" I " \ '_, "" ," " " .>,' kl, ", '~';"F"'", , ", '", _ "',,', .~'. ;,~.,fU.;p::' ,~~/ l' ,~:' .1\.. I I .\"." '~" ',.\ . '" . " .: STATEMENT OF INTEREST A "yes" answer to any of the following questions will not necessarily exclude you from consideration for appointment to the Iowa City Broadband Telecolllnunications COlll11ission. However, the information will assist our Legal Department in determining whether or not there may exist a conflict of interest which would preclude your further consideration. Are you or is any member of your illlnediate family or anyone dependent upon you: a. An employee of or a stockholder in either Heritage Communica- tions, Inc., or a subsidiary or limited partnership(s) (including Cablevision Associates VII), the general partner of which is or is controlled by any of the above? Yes No -X- l' f("() OLlC..e ~ ! Cc\ t'21~C.Ct t1 OY\ I (C,lSle c.~ I/"\'M I II' fiJr .LeeS,!) c. b. An employee of or a stockholder in any radio or television station or news publication operating in Iowa City or serving the Iowa City area or of any parent company or subsidiary thereof, or in any other manner affiliated with any of the above? Yes No hjAf13~ I An employee, stockholder, partner, or proprietor of any corporation or business which has or is likely to have a significant contract or business connection with either Heritage COlllnunications, Inc., or a subsidiary or limited partnership(s) (including Cablevision Associates VII), the genera 1 partner of wh i ch is or is contro 11 ed by any of the above? Yes No4 If you have answer "yes" to any of the above questions, please include a complete explanation using additional paper if necessary. -.. <::l " W :-~ ; " :'2 . ':~l ," - .~ '/1, -, . I ...-:::. .". r.J .'l ". :-: -..." . ..~ E.: .,.. , ) ,'J ''if ", .'"..~, ';'.......' .,-;-',' .' ~',,' .".., ',' '::' .",", ',,::" 'L' . ,[:i" ,.d '. 'It '" ,I'..,'" . ;t,: )+,.,,:: :,',~,::'>::,'\;EJ:, ":!~' ;,,': ,,' : ' , :':' '..::. ":"..' - ...." '" 4UIl......" ,..; '~'.~.. ,. \', I l. BP'ooo~n,~IO T:L:CQ!~MUNICATIONS C0I1/,I[SSI011 APPLICATION FORH Individuals serving on Boards/Conmissions play an important role in advising the Council on matters of interest to our conmunity and its future. Applicants must reside in Iowa City. The City Counci I announced Advisory Board/Conmission vacancies 90 days prior to the date the appointment will be made. This period provides for a 3D-day advertising period and a 60-day training period for new members. The training period allows new members to become familiar with the responsibilities and duties of the advisory board/conmission before becoming a full voting member. After a vacancy has been announced and the 3D-day advertising period has expired, the Council reviews all applications during the informal work session. The appointment is announced at the next formal Council meeting. Appointees serve as unpaid volunteers. Council prefers that all applications must be submitted to the City Clerk no later than one week prior to the announced appointment dates. PLEASE USE A BLACK INK PEN. THIS APPLICATION IS A PUBLIC OOCUHENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC. THIS APPLICATION IiILL BE CONSIDERED FOR 3 HOIITHS OIILY AND AUTOI'IATICALLY CONSIDERED FOR AtlY VACANCY DURING THAT mE. "/CO.HSSIO. 1I.,;a.--w!it,.1 ?;t..unvm.-~ J '~~ . HDI~E ADDRE'sS ~~:O:F~ Is your home addr r~Vl:te above) within the corporate limits of Iowa City? OCCUPATION~" EflPLOYER PHONE NUMBER: HO/'fE BUSINESS EXPERIENCE AND/OR ACTIVITIES ~HICH YOU FE~UALIFY ~)i~THIS JO~I1IOt~ -~ /(- ,,*'71'/'''-'''-' 611' '?-" .Le, .I0/J~ I \.... ~/ J:'&~,.~, ,/ Specific attention should be directed to possible conflict of interest as defined in Chapters 362.6, 403A.22 of the Code of Iowa. Should you be uncertain whether or not a potential conflict of interest ex~' ts, contact the Legal Department.:; Wi1~: you have a conflict of interest? YES I NO : :' ';.. - I ',," ~';1 '~ If you are not selected, do you want to be notified? ~YES ~~~:. ',,) ';'; Do you currently serve on another Iowa City Board or Conmission? ~y~,: ~~. NO: It has been Council policy not to permit an individual to serve on twb;Boar~ or Conmis- sions at the same time. ,J June 19aa iet'l I - - ........' ,':, :'L"!):' "al ":"";::( ,: "'1;~;r', ,:- ,<..' , ;, - , . : ,~lii:',:~;(_..::,{:}::-, ;',,(~'~::' ,: ',--. ,:,:. ::--. >'.",<',: ,." STATEMENT OF INTEREST A "yes" answer to any of the following questions will not necessarily exclude you from consideration for appointment to the Iowa City Broadband Telecol11llunications COl11llission. However, the information will assist our Legal Department in determining whether or not there may exist a conflict of interest which would preclude your further consideration. Are you or is any member of your il11llediate family or anyone dependent upon you: a. An employee of or a stockholder in either Heritage Communica- tions, Inc., or a subsidiary or limited partnership(s) (including Cablevision Associates VII), the general partner of which is or is controlled by any of the above? Yes No L b. An employee of or a stockholder in any radio or television station or news publication operating in Iowa City or serving the Iowa City area or of any parent company or subsidiary thereof, or in any other manner affil iated with any of the above? Yes No X c. An emp 1 oyee, stockholder, partner, or proprietor of any corporation or business which has 0" is likely to have a significant contract or business connection with either Heritage COl11llunications, Inc., or a subsidiary or limited partnership(s) (including Cablevision Associates VII), the general partner of which is or is controlled by any of the above? Yes L No If you have answer "yes" to any of the above questions, please include a complete explanation using additional paper if necessary. ~ ,~ -~ - ;{;-w-, ~, trl1-7'~~ ,,'// f/;4<l41t:e, W ~~.4t/~tt< t4~ ~H/1~~t? /;Rt~,d ccp /r.;jt,1~.'1- k tt~, , " .:i '. " ::, '~ J J ,- r.l) ~.~t." -.. " ,.' , . , :~ , -' c~:' .. .. '.:J tv ~'1q