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Home My WebLink About15-035ria gap CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (3 19) 356-5497 FAX 1. Name l;.VglEu"°U11f'0I1)) „ D NPRC TION NO. _ ..... ....... ( t1'1ice Use olrlily) AIPPLICATiON FORd "R'AXiCAIB I MOTOR RED PEIDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday ..- Friday) yfi 111 e /a✓ � �C,L I � �!,.( .�; (�„ l b 1/, � m' �)„ I /�i Jr+/'/'I a�ip,W, i V' � I� I ?.,Illie I /i C�l';�c 4/ u/ 7„/l, SPI r(71l al l"a (,4 Middle 2. Address (RlI:QII I:UEII',DR 3. Contact Information (I11:iEOUIIRIIE:: D,y Email:, mta ��.� >S46 5a g',o.„y�._. raq Cell Phone:..�.�.��......��. (Ali written comtnuniraticn Brit via email) 4a. Chauffeur's License expiration date (11: yE(DI,.fl1l:iED) „_,_,_,_,_ .iao_ _ _ _,_,_,__,,,,m_ b. Taxicab Business Name QR11::u„tI.,IIIIIII ID)__ aM. ),.e.I�,)._� ,r ;: _,__L ,_M a JCL _-L4_,_,_,_,_____ ----------- 5. ___5. Prior experience in transportation of passengers� 61 ------------------ ,,, 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? `v°a I yI'be of al`'eIn.s@ tmwi C Wlh{.eir a What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended r Plead Guil Other Have you been arrested / charged with any traffic offenses in the last five years? T�.ga:..pff,p) gnap.. Where What happened to the charge? (Circle one) Convicted Dismissed Deferred When Suspended Plead Guilty Other 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Type of offense om When 9. Have you ever applied to bean Iowa City taxi driver using a different name? If yes, please provide the name(s) DEPARTMENT OF CRBiMIINAI.. INVEaT11GATION (DCII) REPORT ANIS STATE CERTIFIED IDRIVMG RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIIIEF REVIEW You must alpply for an individual Department of Crhmnlunail Investigation Report (form avaRllabie upon request).. (SECOND PAGE FOR RELb.LIIRERD SiGNA-f- RRE AND NOTARY) 02/2015 APIA',ILJICginONFfiNRT"a2XCa 113 NliiiiHlCll..lil:::::ICIrtIAli"t:I'2 Page 2 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number `� 4 (v A A 4 5'�3 issued on a aot expiring on ®a to 3 (aoa.a . I understand that if I falsely answer any questions in this application, that this application may be denied. I agree that in making this application, I consent to allow agents or employees of the City of Iowa City, Iowa, in their discretion, to examine any and all records and documents relating to this application, and I further agree that, if authorization to be a taxicab driver is granted, to comply at all times with all of the provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) Signature of Applicant [ a p Tanta e STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed sand sworn to before me by .. ",. •a f,.reI\a` an this day of „m the State of * * s 4 i * ! i A or welfare of residents of the City of Iowa City (Title 5, Chapter 2, City Code). Sing ....................................... t'yate ................................................. re'""af PM Chief or designee AFTER APPROVAL BY'T'HE CITY CLERK YOU ARE AUTrHt RIZED'TTO DIEaWE ATAXIICAB IN IIOWWA CITY FOR NO MOIRE THAN ONE YEAR IFIF OMI'rHIE DATE LISTED BELOW THE EFFECTIVE DATE WWIILIL MATCHTHE CHAUFFEUR'S LICENSE EXPIIRATIIOIN IF LESS THAN A YEAR. Signatu a of City Clerk or designee Office Use Only Approved application DCI report State certified driving record Website update r2,'„... t . D� o CletWfPJUDRIVMDGEAPPL92014amended.DOC 02/2015 €eb. 16, 2015 8:51AM Div of Criminal Invest gation No. 0334 P. 6/6 D2®o�.tu 1,li,e14uw Cab u1 iuwa ,icy (Fax)3183382708 p,002/005 STATE Criminal History Record Check ,Request Form n,h1n� Ton 10wn Division of Crlminal Investigation Support Operations Bureau, I" Floor 216 R. T° Street ])as Molnas, Iowa 50319 (51S)725.6066 (515)'725.6080 Fax M XXI Account Number., 9967-F PA Box 428 (919) 3389777 , Phonoi Fay: (919)3S9W7301 ems. (Do] use oa14 As of �t `� 11 s a search of the provided name and date of birth revealed: No Iowa Criminal History Record found with t9C1 Iowa Criminal History Record attached, IICI 9 DCI initlalta DCX -77 (08/25/10) Received Time Feb, 12, 2015 2:22PM No, 0905 Feb. 16. 2015 8;57AM Div of Criminal Investigation No. 0334 P. 1/6 OV i.1 Cu 1., 1ti110 rniiuw Cab u. Iowa t.iry (FAX)3183382708 P.003/005 101 sn�STATE OF k Request t " of driminal r' on OperationsSupport Moor Dint koltrop, Istivic 50319 (515) 120-6066 1' DC1 Account Number? _9967-F (ItippRoob"", From" RM Box 428 (�x9)�S&d4797 Phone: Tint q Any 911410101 hisgor/dact odfloarsial Me that h "allowed bylow, Me Division vicaminal 1, k (Dctun; only) As of. %�� e^a �® p search of the proAded cameo and date of birth revealed - No Iowa Criminal History Record found with DCl ?' ! lowa Criminal History Record attached, ISCI COs DCI llritlaht D0I.77 (08/2S/10) Received Time Feb, 12. 2015 2!21PM No. 0905 Feb,16. 2015 8:57AM Div of Criminal Investigation No. 0334 P. 2/6 02/i:ai2uis la:ltirel low Cab of Iowa City (FAX)3183362708 P.004/005 care epp� STATE (tHistory , Request Form DCI Account Number; 9967- n..�„®tif appPPaa6ta) TOO Iowo Division of Criminal invostlgotion From; •Y'allow Calb orlowa CI Support Operations 9ureelt, I" Floor a a oS 42t1 213 9L 7 Street Des Moines, Iowa 50379 Iowa 471% , 52244 (515)725-6008 (515)•7256080 Fax (319) Saa®9777 rlitsnai Fax; 95 39 WK Obtain 0 WAIver Insturb from file So b er (OCI uAe only) As of ft sdarch of the provided name and date of birth ravealelh IJ No Iowa Criminal History Record found with DCI P�' Iowa Criminal History Record attached, DCI k �-3%p50'-;r DCI initial DC197 (09/25/10) Received Time Feb. 19. 9ai6 9:97PM No. 0906 Feb. 16. 2015 8:57AM Div of Criminal Invest 6ation No. 0334 P. 3/6 Ole Iu eu to Ia:lural Iow Cab of Iowa City (FAX)31933827os P1005/005 �•-ITM' 4 ATIE OF i k� Criminal Historye r11. Request Tot IOWA Dlvlelon of Criminal Investigation Support operations Bureau, I" Floor 215 Z, VII street Des Moines, Iowa $0319 (515)'725-6066 (515)'725-6080 Pax D01 6. Number., Prom - Yellow Cab of Town C1 IOWA City, Lk 52244 C,�I9) 338-9777 Phone; Pax: (319) 339-7302 �",� � P�s1a etuale Watber Release: I beraby sive permleslon for the above requeeting otOchl 10 00116110114 (owe erlminel historyheard Cho* wllh the Division otcriminei IAVIIII9e110n (1)CQ.- Anyeriminel hinory deal 0000em111em0 the( Is mol11lained by Iho DClmoy be raleaaed u dtowee by law Walt«ew ,sl�rraredys: ll - root ase.anly) As of `6 i�" a search of tha provided ginno and date of birth rovealcdt No Iowa Criminal History Record found with t)CI Iowa Criminal History Record attached, i)CI s' Del 1pitlale. DCI -77 (08/25/10) Received Time Feb. 17. 9014 9:77PM Nn.0906 Feb.16. 2015 8:57AM D v of Crimina' Invest gat on DCI:00356308 NAME: CASTILLI,SUSAN CASTILLI®SUBAN LEM CASTYLLO,SUOAN LASCHKE,SUGAN LEE HIELL,SUBAN LEE MIELL®SUSIE DOB SEK RAC 19670203 F W ADDITIONAL YDSNTYPIERS SC L CHK SC L FGR SC R LEG SC R SHLO SC R THUS TAT CHEST HGT WGT EYE HAIR SKN BOB 06 130 BRO Bliff MED it CCH RECORD www O1 ARRESTED 19870103 AGENCY; IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI TRK#: L31555901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE IA321J.2 OPER VEH WH INT OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#e L31555901 SENTENCE JAIL 2D FINE $500 02 ARRESTED 19911111 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO— 01 IA STATUTE IA321J-2 ONI/2ND OFFENSE TRK#: 1,31556001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(B) OPER VER WH INT (OWI) / 2ND OFFENSE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L32556001 SUBSTANCE ABUSE EVALUATION SENTENCE JAIL 7D FINE $750 DISP EFF OAT 19870220 19870220 No.0334 P. 4/6 Feb.16. 2015 8.57AM Div of C r minal Investigation 03 ARRESTED 19950612 CHARORt POSBEGEMON/CONTROLLED SUBSTANCE 014024302 COURT DISPOSITION AGENCY: IA0530150' JONES CO DIST COURT COUNT NO- 02 IA STATUTE IA124-401(5) POSSESS CONTROLLED SUBSTANCE/MARIJUANA 0BAR GE CLASS, MISDEMEANOR CONVICTION TRKO: 014024302 SENTENCE DISP EFF DAT FINE $250 199706.17 04 ARRESTED 19970512 AGENCY, IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI 2ND OFFENSE TRK#; 028039201 COURT DISPOSITION AGENCY: IA052015J JORNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(B) OPER VER NR INT (DWI) / 2ND OFFENSE CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 028039201 LICENSE REVOKED SENTENCE DISP EFF DAT SUSPENDED JAIL lY 355D 19970813 JAIL 3651) 19970813 FINE $750 19970813 PROBATION 2Y 19970013 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION No. 0334 P. 5/6 Name: Phelps, Susan Lee DL/ID: 846AA4543 Pursuant to Iowa Code §321.10, I, Kim Snook, Director of Office of Driver Services, Iowa Department of Transportation, do hereby certify that I am the custodian of the records held by the Office of Driver Services, that this is a true and accurate copy of an official record currently in the custody of said Office, and that I have been authorized by the Director of the Iowa Department of Transportation to so certify. In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: 2/12/2015 SIOWA 13 0 T, A. u Iia Office of Driver Services m Iowa Department of Transporation Certified Abstract of Driving Record Inquiry Date: 2/12/2015 DL/ID #: 846AA4543(IA) Customer : 5084794 Name: Phelps, Susan Lee class: D ID Status: EXP Address: 1206 E COURT ST Audit #: 7769558 DL Status: VAL Issue Date: 02/07/2014 CDL Status. None elty/State: IOWA CITY, IA Expiration Date: 02/03/2022 CDL Cert Status: None 522403234 Endorsements- 3 CDL Med Status: None Mailing Address: 1206 E COURT ST Restrictions: NONE Restriction None Supplement: Date of Birth: 2/3/1967 Mailing IOWA CIN, IA Sex: City/State: 522403234 History Information Name: Phelps, Susan Lee DL/ID: 846AA4543 Pursuant to Iowa Code §321.10, I, Kim Snook, Director of Office of Driver Services, Iowa Department of Transportation, do hereby certify that I am the custodian of the records held by the Office of Driver Services, that this is a true and accurate copy of an official record currently in the custody of said Office, and that I have been authorized by the Director of the Iowa Department of Transportation to so certify. In witness whereof, I have caused my signature and the seal of the Department to be set upon this document, at Ankeny, Iowa this date: 2/12/2015 SIOWA 13 0 T, A. u Iia Office of Driver Services m Iowa Department of Transporation A i ! 4 H