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Home My WebLink About15-021CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (319) 356-SO40 (3191 356-5497 FAX 1. Name (REQUIRED) 2. Mailing Address (REQ Authorization Number—L5=44_ (Office umber;° °- (Office Use Only) APPLICATION FOR TAXI / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) EP140w 't r r frd a _((t 9L w in—farr'7afirda_v_o ill resfit h'iotIis I of t6a 2200vt211 3. Contact Information (REQUIRED) Email:l t' JtAAo ! ®{„ L ay,,zh-r, Z ell Phone: 31'9- 41 0 °°° >113 m 4. Prior experien in transportation of passengers: 41a. 14In_/Isrp� t., X10 _ �'�Cy�r��, ��a�ad 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or els ""'"0 7''MAW"" 14 e of offenseWhere an, 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? i. Have you been convicted of any traffic offenses in the last five years? Where um When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 74- S Type of offense Where When ------ -- .__.._.------------------- ._--------- ...—.,—,.---------- —--.._.___.._____.. 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide thd pame(s)" DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REMEW You must apply for an Individual Department of Criminal Investigation Report (form available up" request). (OVER FOR REQUIRED SIGNATURE AND NOTARY) 09/2014 Iereby certify that I have issued to me by the Iowa Department of Tre.nsportadon a valid Chauffeur's license number 7FS L �0 0 I understand that if I falsely anSWer any euestions in this application, that this application may be denied. I understand that if I falsely answer any of the questions in this application, that this application will 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 a license is granted, to comply at all times with all of the provisions of Title 5, Chapter 2, of the City Code. jN1Pv?r:, to l« elgna4 int f er tr ntf n. Mstepj pv Bic) Signature of Applicant •w r° Date—/:�;,�Co �S YOU ARE NOT VALID TO DRIVE_ A TAXI IN IOWA CITY UNTil- AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. STATE OF IOWA ) COUNTY OF JOHNSON ) and sworn to before me by _1 � - Ck. I ) I r rl®. On this "7 t Jn day of the State of *ki**k*3*d****kkd*kdYddi*ikiiii***ddd*3******3*d***34kkk3*33******dkd***d******3***ikiiii**333*iikii**3*dR*R*ddd*kkkddd}ddd**************3%33333 I have reviewed this application, DCI report, and the State certified driving record of this applicant and have deter- mined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of residents of the City of Iowa City (Title 5, Chapter 2, City Code). alga Signa re of P is Chr or designee /—,?, 7 /�— Date YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. Signature O'f`City Clerk or designee 7 -- Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 %" (width) and 5'/:" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update ClerkrrAXIDRNBADGEAPPL=14amwded.DOC 09!2014 °1�iiip110 Jan.,21•7 2015 4:10P� Div of Criminal Investigation II • SV LV 1J1VA4 ..{y STATE OF IO Request Form .Iw•.Kutau�.�A.�veNnNdd�ao'�w'p�wvgwa��7Cwm k,arflGuwn ��nrcYnYZew 0 �rt"arsffgaruur �uaicrawnaN, �."°.Y$ffeaer weet Yoea IvleNaaer, Iowa M19 (515) 724.6090 OAK Owe iNo . 0512 JjUUiP. X1/2 City ry�p�a�yR� 4 0106 y� 'RM.Vd D�+x. W®'FY%+ACllllil NXM M1'•TA��T.N� Yaew,w Q.k'ffgT, TA 52260 l¢ awueY „ A -35h iP.... . ....... . _. .. Ykawr 07[x-iNa66,@� i m�dww a��wd mwaavt��Yda 6 �N aYwhY s sIgnedadweeir ky°mudw the iswdb.Tde6o9fh a raggest, a aaruu pWe eflW nal hfstoiry record ui gy not OYe regensebla, per Code of Yowwn, Chapfor 6.92,1 For &Mpj@9 OVIM11,101 NuN 6rY reeo9rd.IInfferwdaedon, Re allowed by low wwNwr r I'PM wr�•W�N'.�'dd��°�`�'�°, APatrctr�,��Nw�g�rrvpYkwdl'vraa'kbru'�as �'ke�mrn irr�guup.�renuv ?I N. iie mayuuddrsmk mlm Pa"�aa oxd'nYaGwa�w Fhiuxgycrggruc�esdl:kYe.�'¢x�'Yka Yk,m��aNreCoaw ak'�I'ldaa&auk Yaa�drixNB�ruR96xeQG.7&sky..eagpczs"aaYr�Ysnkke@'s'bmr�kY�tr%era4Yespayd, mrtrQ'ktiGa6Rs �kcakA Ihq✓p3uw:a1$;ftrcnrare'Yxtrdrokwa�r..d ua�l'kervwrrcRYappRwnuv. elb e? ffigne ur"e° .w..... �.. ltY*a Cifirdnal.History Record C As ash ...... da sosreh aofthYa;Vr ovided namo aarekal W6 a¢fblytla reyeaale& �� „•� No Tovfa CrI m:Inal T4.a.3twyRecordo undw. thJ..7Cl I(arvra moan"nal, IfistoryRecorduu'Ekach.e N,DM ......._.... Iteceured Time-)an.20.-2015- 9::3'IAIW-No, 629' n1IT 77 MMV9fl\ Jan. 21. 2015 4:11PM Div of Criminal Invest gation :IOWflA. CRIMINAL 1191STO.F.tY DCI 00425268 M4ISDEMEANOR CORVIQ:TIONS ONfeY' PAGE 1 OF 1. DATE PRINTED... DCI,0042526a 2015/01/21 14 E: WILLT S,LY VA,kj, DOB SEX RAC HG"T WGT EYE HAIR SKU BOB 19671125 M W 506 195 BRO BRO I,GT :T.A ADDITIONAL IDENT:IFX'ERS SC FACE CCN RECORD *** 01 ARRESTED 19910601 AGENCY: IA0770300 DES MOINES PD CHARGE NO- 01 IA STATUTE .I.A725 -1 TRK#: L40332001 COURT nxSAOSI°TION AGENCY: IA077015J POLIO CO DIST COURT COUNT NO- 01 IA STATUTE IA'725.1 PROSTITUTION CHARGE CLAM NX SDEMEANOR CONVICTION TRK'Av L40.3.92801 SENTENCE FINE $300 WEST DES NoiNES IPD I:A STIµ."ll.UTS 'IAe.'714-2..2. PO:rK CO DIST COURT ':1A• STATUTE 1A711.4...2 (2) a No. 0512 P. 2/2 PROBATION 2Y 19960131. '2'Y VSEM^°V'v8IX8IdY?D uaYCDGS...:A.20 HRS COMM SERV. ,. AN ARREST WITHOUT DISPOSXTION IS NOT AN INIIICATXON OF GUILT. THIS RECORD INTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OV IDENTIFICATION IS A PUSLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENT AGENCIES $Y THE DCI. IN THE ABSENCE OF P!r.XGF)RRRINTq FOR POSITIVE IDIFNT:IFI 'TION Tl4d'.IS RECORD Is , RASED ON INFORMATION FURNISH13D. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY.. DIVISION OF CRIMINAL INVESTIGATION iu.r y� oar OL/sO #e MW Cuustaamr fift 4832290 ��% R��Jo YAMY� M.d'1i;. m � Williams, Lynn E S�pi�ARI R VI tk��p��aLER I �.� h IDM R �DINVEIM unnuwiwwmw nm WIWIO�G None Addresm 320 2ND ST AFP 127 alII of IDrrver Selvi¢:es 8782002 DR. rtatase VAL 11 110 li 9204 p 111 Muativaes, pani,"'ulll"fIXMk 0204 O1.10912O 4 ............................................. _............ :taste Dai Plilori df p5: -Zp4-a9 IM18u¢C"412.112111 F-a"♦LW'i,:5 5,r^391..�037 None Cllty/s1tateu a)RAI..VII.6..E, IA W'iMMP.Ialvaluial,gay Car'drified All raF. Of IlDrIving IIS.. did Inquiry ten 1/27/2015 OL/sO #e 878AL2002 (IA) Cuustaamr fift 4832290 Namem Williams, Lynn E Cpasm D IIID Status: None Addresm 320 2ND ST AFP 127 Audit M 8782002 DR. rtatase VAL Suspended ........... _. _.... _.............. ...... O1.10912O 4 ............................................. _............ :taste Dai 01/21/2015 CIIDL Foutum None Cllty/s1tateu a)RAI..VII.6..E, IA ItiziptratIon :1.7./28/2023 CDIL Cart None 52.2412657 DI Statasa Endorsements- 3 CNDII. Med None Statasu Mailing Anddresm 320 2ND ST AFP 127 Restrictions; NONE Restriction None Date of N2rttn, 11/28/1967 ru ppleneeente Etta tiing Cftirfbtaft CORALVILLE, IA S= M 522412657 "IYyline Effective IY^und ACID IExp,ullaunsuttioun .................. Occurrence 'plUllit : Dlk'011t Suspended 11,/'02/2000 02/06/2001 ID53 INoin lPaymeunt. of Iowa IFine %A. Suspended 1.2/07/2000 02/06/2001 D53 IFaH to satisfy Non -;iol 12tatiion QA.... Suspended ........... _. _.... _.............. ...... O1.10912O 4 ............................................. _............ 111 j22/200uP _............................................................................... D51 IWoinI-Payment of d',IhIIld SUIPPOrt _....... .............. ... _.... ,. _........................... _... ................................................................................................................................ lA ...... ._.......... .................................. N M.IW r ^ i UROV milkiiii,^ r M er record currently In the custody of said office, and that I have been authorized by the Director of the Iowa Department of Transportation e,. certify. t1gRff n0o iI 1/27/20:1.5 W oru . Office of Driver Sarvlcas Iowa [)apartrmentofTransportation IMaii Williams, Lynn I.F. DLl 87 L2002