HomeMy WebLinkAbout2007-03-20 Appointment
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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, March 14, 2007. 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 avaiiable 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 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: 3
Females: 0
Council Announcement Date: June 13, 2006; August 1, 2006; September 5, 2006;
September 19, 2006; November 14,2006; December 12,
2006; January 9, 2007; February 20, 2007
Application Deadline: Wednesday, 5:00p,m" March 14,2007
Council Appointment Date: March 20, 2007
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" March 14,2007
IX! Denotes applicant completed the Confidential page of the application,
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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, March 14, 2007. 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.
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-- --'--'--'--'---.-.--. .." ----_.._..,_._._._-_.--_.,._~--_...-..._--_._.._-_...
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; August 1, 2006;
September 5,2006; September 19, 2006; November 14,
2006; December 12, 2006; January 9,2007; February 20,
2007
Application Deadline: Wednesday, 5:00p.m., March 14,2007
Council Appointment Date: March 20, 2007
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., March 14,2007
[8] Denotes applicant completed the Confidential page of the application.
NOTICE
~
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
PLANNING AND ZONING COMMISSION
One Vacancy - Five-year Term
May 1, 2007 - May 1, 2012
The duties of the Planning and Zoning Commission members include making (or causing to be made)
surveys, studies, maps, pians, or charts of the whole or any portion of the municipality and any land
outside which--in the opinion of the Commission--bears relation to a comprehensive plan; also include
recommending to the City Council from time-to-time amendments, supplements, changes, and
modifications to the Zoning Ordinance.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa
City. This Commission conducts formal meetings the first and third Thursdays of each month at 7:30 p.m.
(Informai workshops are held the preceding Mondays at 7:30 p.m.)
Applications must be received by 5:00 p.m., Wednesday, March 14, 2007. 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 Planning and Zoning Commission shouid be directed to Robert Miklo,
Sr Urban Planner at 356-5240.
2/7/2007
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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: 1
Council Announcement Date: February 6, 2007
Application Deadline: Wednesday, 5:00 p.m., March 14, 2007
Council Appointment Date: March 20, 2007
PLANNING AND ZONING COMMISSION
One vacancy - Five-year Term
May 1, 2007 - May 1, 2012
Term expires for Elizabeth Koppes
David Redlawsk [EJ
26 Gallup PI
Dennis Keitel [EJ
1696 Ridge Road
Elizabeth Koppes [EJ
1528 California Ave
(Currently serving 151 full 5-yr term
+ previous unexpired)
Reid McDonald [EJ
91 Charles Dr
lRl Denotes applicant completed the Confidential page of the application.
CITY OF IOWA CITY
Advisory Board/Commission/Committee
r-\pplication Form
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CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees 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).
Retum 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.
BOARD/COMMISSION/COMMITTEE NAME Planning and Zoning Commission
NAME David Redlawsk
HOME ADDRESS 26 Gallup PI
Is your home address (listed above) within the corporate limits of Iowa City? [{]Yes
How long have you been a resident of Iowa City? 7 1/2 years
TERM May 1, 2007-
ZIP 52246
DNo
nCCUPATION Professor
PHONE NUMBER: HOME 354-4532
EMPLOYER UI
BUSINESS 335-2352
EXPERIENCE ANDIOR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I served on a planning commission for a number of years in a former community - including 3 years as the commission's Chair.
I have extensive experience with planning and zoning issues. I routinely read materials from the American Planning
Association, and back when I served on the commission I was a regular speaker at statewide planning meetings (in
Pennsylvania) as a citizen-planner. Following that experience, I served in elected office (City Council) in another community
(this time in NJ) where planning issues were the top issues of the day. I spent four years on that Council addressing things like
affordable housing, scattered site and inclusionary zoning, managed development and new urbanism, and a range of other
issues. At the UII teach local politics, which includes a significant segment on planning and zoning iss~,;;. ~'.'
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WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
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I feel I have a pretty good grasp of the issues facing the commission and the city. I was an active parti9iPant when the city did
the planning process for the southwest area (in which I live). P: Ul
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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
November 2006
Page 1 of 8
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR
APPLYING) ?
I bring a wide ranging perspective from both living here in Iowa City for nearly 8 years, and having had significant planning and
zoning experience in two other communities on the east coast. This allows me to both understand the current issues the city is
addressing, while bringing experiences that may allow occasional "out of the box" thinking as we address our challenges
moving forward. Planning and zoning issues define the future of any city - how will we grow, how will we build a livable,
sustainable community, how will we handle the challenges that come from growth, and so on.
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
., ,t apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.
~ ,ner 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. ~~
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None of which I am aware.
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IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 0YES DNO
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES
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0NO
(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
November 2006
Page 2 of 8
BOARD, COMMISSION, & COMMITTEES
BUSINESS LISTING
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CiTY OF IOWA CiTY
Name of City
Board/Commissi on/Committee Planning and Zoning Commission
Name David Redlawsk
Date 02/27/2007
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
None
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NOTE:
A new form must be completed if the above information changes or an ownership interest
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Signature
Address 26 Gallup PI
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
November 2006 Page 3 of 8
City of Iowa City
Advisory Board/Commission/Committee
_ "pplication Form
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CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees 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.
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Advisory Board/Commission/Committee Name """'''''\\j \ -C()\,\'''-,'I O_"'^tS~1 Term 2007- <.-u 1..
Youth Advisory Commission, Age on the date offiling:O Age 15 to 17 (or) 0 Age 18 to 21
Signature of parent/guardian if Age 15 to 17:
"AME {J~",V\\S J. I<~,+~(, p.t_
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HOME ADDRESS 1()90 ~'iJ5~ ~{)o.J.)Io-....Jc. Cl-h }LA ZIP
Is your home address (listed above) within the corporate limits of Iowa City? 0Yes
How long have you been a resident of Iowa City? IS ye<\ rs
OCCUPATION C.i\r~~ eV\jlk.,~V- EMPLOYER Hall ",,,J 1-1(111 E.."'.)7M....6,"J:~
PHONE NUMBER: HOME 3' q - 35'+ -/9 4-9 BUSINESS 3\ "\- 3 6<" -"I S""l-0
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
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Misrepresentations on this application will constitute just cause for removal of an appprnteEh)f YO\:!-fail
to answer all the questions, Council may not consider your application. ,~ ;:~: :iY. ,-"-;
".1 :~.;: ........., ::: ,...-j
General Application
December 2006
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Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
..1: ktt.v't. dfP~V"'t.J- ~-efoy< f(c..",V\-;\.., c;\I.-,J ~'O",I~ CO'-''''^\55~~l,.
''"~''''"Y t-\""-t-S (~ fast- w(-i!-€- ~'^'f}O.7~ .br w\\.\,\S (()VOSL.,.).}",,,h.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
-.:c Vv<t..y t-~ <o",j-''-\,\k€. s.e,YvicA- +~ {oedl j(YV'l.V"'....~l"t
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<-VIii ~e c:t 7 K<'At d.sJef- +0 Hvl s blTc.....4,
POTENTIAL CONFLICTS OF INTEREST
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Please identify any potential conflicts between membership on the advisory board:app YOy!, perso~al
interests, including financial interests and your duties to an employer. - - i' ::-. ,j
'"~_.
-- -
.--',~'-- --
. particular, if you are applying to be a member of a board or commission which makes recoirlli;endaiiGns tothe
City Council about the allocation of City funds, please list any present affiliations you have lVith agenbiesthat
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'f'1" o.....{., a>...f i.-d <..A..-e,..."f b-e. ..(~I,(e. 0,0 ~'^'+ lIvor .do~
47 I!Q.{I 4~ H..O I>-h.JI ~Y.$ ("'- I6.......<\ Cib. c"'...te'\.H)' I ~~ t-tIt.
"'II VvD...-k 11..._ :r o....,.~ Cr+r.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes D No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~s D 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
December 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
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CITY OF IOWA CITY
Name of City
Board/Commission/Committee
Oe~V\-\~ T-
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Date 3-7- D7
Name
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
f..{...1I '" 1....1 1-1....11 t:u-i.. u,vs Ir\<;', j&b{) ~^,-se", ~ Ocl.....l
J I J../;d.\A.A. .f-t...... :r:A S:>.G ~~
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NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an ad~~nal busines~, /J \
Applicant Signature bJ /~ JI.~\
Signature of parent/guardian if Age 15 to 17:
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Address (>/ f\ ia:J~ I<...Oo.c:J. I .L-<h.,...... ~ ~~ ~"":t:-':>
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Misrepresentations on this applicatjon 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
December 2006
Page 3 of 7
City of Iowa City
Advisory Board/Commission/Committee
\pplication Form
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CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees 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). Retum 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/Committee Name P
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Tenn tt1ro) I, :)t\ I')
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Youth Advisory Commission, Age on the date offiling:D Age 15 to 17 (or)
Signature of parenUgual'dian if Age 15 to 17:
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Is your home address (listed above) within the corporate limits of Iowa City? I1J Ves D Nbn
How long have you been a resident of Iowa City? ~ t'" r-<;
OCCUPATION <;o+-\'..(AI~ ~~.J~ \Cl fRr EMPLOYER Y .Q..."-r<; Of)
PHONE NUMBER: HOME ?'I" ~ ')'Y 12, ~\ BUSINESS ~ \<1 :;')~-9 ~(jCl 7'-fa IrH,
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
:r:.. h....,,~ S"r 'lit c\ G" -\i-... ~\b.O')"'~J J-. m:\'.,'j c.omff)';S1)i"C\~ for
S 1/2 ':}R."'<-~ :J.. ",\so c.uY\ Vl'Jj \A.va\vl',,<l \^ ()')j
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NAME 0 t ~ Co. b.>-\-h l\.D i'Y<2 }
I.OMEADDRESS 1'1,9..$1- C...\ .k'll"
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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
December 2006
Page 1 of7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
'Th... bOllr<l.. 6..0C) (<'CONI'Y. :>v\;;>~~' j'.",n'l c.od.. '"e c.<_-\c.s, v a..C-d>.dl1-, ~,-",l
p\I)..-tJ. T"'L \;>C"r~ '<Joe\<.) ""'w. skff -+0 Yt\.....\q ~H_
rt.c..O\1\"'l('~r-.:hQ/"lj +c, c ~ C.<NI'-'" I.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
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1-, .1-. -'r~'
0... e.T,an 5 6f:f'\i()('\"O "
i C\ -1-ht
t') e i 1 h !>orh<roi
bc["rd,
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.
I" particular, if you are applying to be a member of a board or commission which makes recommendations tothe
ly 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 362.50fthe 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 ofSeclion 362.5 is
attached (see page 6).
:i-:r~
-'\:> =---;, S'U
~,
._-~
I l
0.)
-,-1
, I
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes o:;N~..,~;
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSIO~ ~ ~ D 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
December 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
I! 1
;t~~~*t
-..:::.... _...~
..... -
CITY OF IOWA CITY
Name of City
Board/Commission/Committee f )4n fJ: 'j J- b.r,;f) (U/)1I1l.JJ; <.J/")
Name E. l; 'Lc.. b..Q-Ih ) "-D? pc.J
Date 3~ 1;;).~U7
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
LlnLO n, 17>0 /) (fn -h J- [A\\p<.:hi.,lu }<),9.fr (" \~,~~ ~ ~ :]oiJ.k U{--..,
.J
C~.._
~ '::.:..-'
c'.".',
~-- J
.,.."'"= \ h'.
)>-.--.. '.
.
c:::' w
,-', '-, ' ,
:.~ ~...-. '
,-) :::~; '.j
>- _.
"""
Ul
NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant SignatureCl~ ~
Signature of parentlg~dlan If Age 15 to 17:
Address K~1r C" j,-f:;//);... ALi--Q. Je~~ C~
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
December 2006
Page 3 of 7
City of Iowa City
Advisory Board/Commission/Committee
Application Form
I ~ 1
~~~'t
~~r~'~
Guy OF IOWA~TY
..
f ,- J
". - . "
Individuals serving on Boards/Commissions/Committees play an important role in ad.'J!.sing lt€:COL!rfCJI 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 theiVork session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers-:-fhis 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.
1"--'
Advisory Board/Commission/Committee Name /0..
/
r 2<'Y7/'-"'"
Term -s;/f'7-~~JL
n ^ge Ht~21
L-t) ~
<C~> :':;~:
~:.~, "'..."
Youth Advisory Commission, Age on the date offiling:O Age 15 to 17 (or)
Signature of parenUguardian if Age 15 to 17:
""-'
--n
r,
.-
lAME ~A' X /J~k
HOME ADDRESS 9/ ~/.~ ./1.-. ~Sff~";:i
'Is your home address (listed above) within the corporate limits of Iowa City? 0Yes []'No
How long have you been a resident of Iowa City? ,3R..5- J ~<<rS
OCCUPATION 0'~<<?7/ /-t~d;JR.+-- EMPLOYER ./-;;{jM~.I..{ ~f1c,,/
PHONE NUMBER: HOME .354-30"1/ BUSINESS 337 -3737
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
-~!(
~
T]
_c'.' r--
/gU/~J' ... Itjl>>>L- r<-5,,:I,-1 d.j' /. {!, 11:/ .L A<<'G <<--
j/er ]~ ~/~J 0/ /IL- 2m_? Qrb",A'O- aA'."f /;:;, c/,11~wl
G'''{L" :If~l r::-/h_ .j.; #iC t.~>>1i;''S,~. 4;{,,, kj t1: ~"'---! -/
"'- 1.'=(/,/ ~ -L,/Y .tUSii"~SO "'-;20 'f'AA'J 'l N~s f'VVL" J'J-.rd v</"rl..-,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.
.
General Application
December 2006
Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
/~ wLl1 ~du-sL,.,<IJ,~ ,j~4 rL-Vi.45 'l'fJ!w../ffiS k- Zif>7)yyJ
r7'~51s ~ J-r1. /v.rn rYl"lJ.e.s recc-?'Mu.A1d""/'~5 -/.:; ~
C-r / .
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
~p~, .<<$ q Ii -/:-11n-tL
/' l1't~ar/~ o-{'
~ G_a ./'!~f- .. <
ns'bl v 5- A.j -L--
,
usJ."ess
~i~
~J Jl-d-uJ;k /7-Pr~
S-4-i,HA-5 CY>J'>r'ac4 h "I' //7 ~'5 u.,tu.L
k
ct
t...,.~
Q
c:;.
-.'
::::.:
"r:-
-Tl
,
.,,-
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the
interests, including financial interests and your duties to an employer.
[
~---r-'
-rj
:::;:1'0 ~-~J
y~r per-sonal
advisory boar~2~p
)>
--l
In 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 knowthatSection 362.5 ofthe Code oflowa 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).
i_."
If you are uncertain whether a potential conflict of interest exists or have questions aQ!;iut SedtiOn 362.5 of
theCode of Iowa, please contact the City Attorney's office at 3.56-5030.. ;-,,~ ~ -' ~;-"
T1
~
i I
",--
~.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? BYes DNo ~
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? 0 Yes 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
December 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
I ~ . j
-....= -u:a-
:f~W!:'!:
~.. ~..,~
.."..~
CITY OF IOWA CITY
Name of City ///
Board/Commission/Committee /" 1aH1/1'
Name E~ n JJm!"/~
,
~
f ~fM7
J
. Date
3/3~7
/ I
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
/vl /L /. O,,';'J It!, It.! s.. . 0..1 I.e.. h c; 2- 2-d t?
c
/ /
1"'_.1
Q ~'';:'
~- ~
::_ ~_.I "
.- -.._,
(-"." -... --_!
. . - -~.
,.~" . -
"-i
.-c- ..' - -,- ::~; ~ .. j
r---"'. .. _-i". ,
~=:/" I....~,
.J> -
-.J
NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
/-"')
L-L.</
Applicant Signature ,/:. ~ ~/ d ~-/
Signature of parent/guardian if Age 15 to 17:
Address '9/ (':.J",,_I-., /L- . /. {: . /.,. S-.2- 2- "/0
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
December 2006
Page 3 of 7
--~-_._------_._._--_._._--_._-,.-.._~_._._-------_.'-.-----.---
Page I of I
Sunil Terdalkar
C;:]
From: Alicia Trimble [aliciamtrimble@yahoo.com]
Sent: Monday, March 05, 2007 10:18 PM
To: Sunil Terdalkar
Cc: jdchris@southslope.net
Subject: Iowa City Historic Preservation Commission Application
Mr. Terdalkar,
I recently submitted an application for the Iowa City Historic Preservation Commission. On that application I
stated that I was recently appointed to the Johnson County Historic Preservation Commission. Indeed, on
February II I was contacted by John Christenson, the chair of the Johnson County Historic Preservation
Commission, and informed that I had been appointed to the Johnson County Historic Preservation
Commission. This evening I received a call again from Mr. Christenson informing me that he that there had
been a miscommunication with the Board of Supervisors and I had not been appoint~d to the Johnson County
Historic Preservation Commission. I am horribly embarrassed and deeply regret the information I now know is
inaccurate on my application. Please inform those who will be looking over the applications of this change. If
you have questions on how this error occurred please contact John Christenson at 319-626-8805.
Sincerely,
Alicia M. Trimble
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3/6/2007