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Home My WebLink About14-2511,00—all Mir CITY OF IOWA CITY 410 Cast Washington Street Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX 1. Name (RE::(])JIRE D) Authorization Number Lf., (Office Use Only) C6 APPLICATION FOR TAXI / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday — Friday.) )�=tvrk'rrrr+ a,a 0le-tp_((ae r29!'datq x'!forttatftrr'mrillYeSuflia,dt:�aetsaf)h,g� trrpl�ar� First 2. Mailing Address (REQUIRED) ' S 3. Contact Information (REQUIRED) Email: --fl' 4. Prior experience in transportation of passengers: Middle 6. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where Last When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? Type of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? Tvoe of offense Where When When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? c Type of offense Where When --- .WCL --- m . ._____---._____----- u.° -_______.__ 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide the name(s) DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF REVIEW You must apply for an Individual Department of Criminal Investigation Report (form available upon request). (OVER FOR REQUIRED SIGNATURE AND NOTARY) 0912014 1 herebyrtify th t u have issued to roe ,by ilia lova Department of Transportation a valid ChauffeUYS license numin�Y V n ?5- . i understand that if I falsely ansvier any questions 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 ai!oww 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 limes with ail of the provisions of Title 5, Chapter 2, of the City Code. (Needs to be aEgnsw Pe front of a xctanr Puhi tc; R Signature of Applicant _ .a_ Date � � r 'f-- YOU fYOU 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 ) to before me by _ i T"Q ��S�jd^ On this day of 111 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 !ovda City (Title 5, Chapter 2, City Code). 7 )r _ ,oma Sigrratur "i5f ice Chief or designee ate o.. 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. ignature- of City Clerk or designe %/ j 3 h;., Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 81/21' (width) and 5'/:" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update ClerkrrAXIDRNBADGEAPPL92014=.nded.DDC 09/2014 °1 Nov, 5. 2014 12:31PM Div of Criminal Investigation V'l l,)U, tv 14 L: 7yrIYl trig bler8 - pixy UI IOWA b l}' of ' c. l (�� , t(��1is ( 71 lk, aII'.o'f�.{x y'f i� 1 � ii Toi Towa)[livislon, of Criminal „p, Operations Floor 219 9 7'h Street Des (516) 725-6066 (515) 12je-6080 )Fax l: azxx_n:�adracrad�a' I... ast. ame ro U Ur -\ Date NNu. ))uo. 3530 r ft P. 1/6 , ..Qk£wpppRuedV9e}........................ From: Cfiay aLlgwya �R4W Chy clarwew Office �i:fi.V1 I�. awNxnaagaoaa �8a'ee& _mmpuuw a CityY.... RA....�) � Phone: 319-356,5041. Fain.....p............w................iii°............................................. Social �..0 .,. w G,( ,.... (.A U.......Ir ,,,,,;& (- � g- SR 6Abey.loH^majeow without a Agneal Wnivo:r I1razma thesubject 01'4he wanpnewf, .a complete orlaxlaal bWor,y° word mai anet ha aelo askiblea per Code arl.howap Chapa4ev.6'92,2. Far .p.Qg p Wq crimWaal htlnaaryrev, om6 iianl'owawownklor , as apdo'wmeA by law;, always a&f*a elwAlw�:rakwwwdNaRwelpwanl'aaRoaa a'Qaaam& wo MmweatHaseiosn fia:a4.a�. Any IdHory dam aalluxg xnwa waiver Vw CwFl.49CI M TWA Ila aafWdO.n ed" Q'•ydeaARM I by Uw, u,:.. theprovided. name and date a'f. bix1h x6vealed: 0 NoIowa CHminsalHistory Recoad.rbaand mAthDC1 laa a Crimnlaa rC .I-II.story.l ec and attaclac4, DCI #.. � . � I CI,.Wdal r�nr T inoi�crlm Received Time'Oct.30. 2014 2:55PM No.4248 MCI use only) •Ir A Ndv. 5. 2014 '2:31PM Div of Crimnal Invest;gation IOWA CRIMINAL HISTORY DC:f. 00797997 MISDEMEANOR CONVICTIONS ONLY PAGE .I OF 1 DATE PR:CNTED- 2014/11./05 DC1a00797997 NAME; DICKENS®CRERYL JUNE PETERSON®CHERYL JUNE DOE ,SEX RAC HOT WGT EYE HAIR Y.KN POE 15600614 F W 511 325 BLU BED FAIR IA ADDITIONAL ID'ENT15"IERS PHOTO AVA'ILABLEa Y CCH RECORD mss 01 ARR99TED 20070301 AGENCY! IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE TRK#= IAOOOXPoi COURT DISPOSITION AGENCYD IA052015J kTOlMSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124.414 POSSESSION OF DRUG PARAPHERNALIA COURT CASE XD; 06521 SRCR078311 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1A000XF01 SENTENCE DISP lWF DAT FINE $100 20070606 11% ARREST NIT&DIT-YISPOSITION IS NOT on INDICATIOA, OF Gi THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BURRALYj OF IDENTIFICATION ., BUT CAN ONLY BE RELEASED TO NON -LAW ENFORCEMENTM 114 THE ABSENCE OF FINGERPRINTS FOR POSXTIV8 IDENTIFICATION FURNISHED.]BASED ON INFORMATION COVERS i DIVISION OF CRIMINAL INVESTIGATION F No, 3530 P. 2/6 gg DOT WWwAnwadot env SMARTER C S(MPHF I CUSTOMER IPRPVE%J . aMlk Office of Driver .Sawces PO Box 9204 ? Des ROnes, I,A. 5030C 9204 Phone. 696-244-9124 6 5l2-1121 1 Fax, 515-239-1837 as°aster"Imw,iti,�+F.. go - Inquiry Dates 11/12/2014 DL/ID #. 556YY1175 (IA) Customer #: 3689501 Name: Peterson, Cheryl June Class. D ID Status. VAL D53 Address: 2221 MUSCATINE AVE APT 2 Audit #. 8610921 DL Status: VAL 07/08/2013 D53 Non -Payment of Iowa Fine Issue Date: 11/12/2014 CDL Status: None 06/12/2009 City/ ate: IOWA CITY, IA 522406536 Expiration Date: 06/14/2022 CDL Cart Stohasr None Suspended 08/27/2009 10/21/2014 Endorsomenhe 3 CDL Med Strauss. None IA Mailing Address: 2221 MUSCATINE AVE APT 2 Restrictions: Corrective Lenses Restriction None PA IA Suspended Date of Birth: 6/14/1960 Supplement: D53 Fail to Satisfy Non -Iowa Citation Mailing City/State: IOWA CITY, IA 522406636 Sex: F Suspended...............0.1,/2,0/2010 10/05/2014 D53 Non -Payment of Iowa Fine History Information IA Convictions ti' ita'tlain Date Cenvili'lion Datr, A411) ExplalnaAaon County .IDR, 11/25/2007 02/21/2008 820 Driving While Suspended, Denied, Cancelled, Revoked Johnson IA 01/18/2008 02/21/2008 B20 Driving While Suspended, Denied, Cancelled, Revoked Johnson IA 09/27/2008 11/19/2008.... B61 Violation of Accident Requirements Johnson IA Case INnumbelr JU R IB 456934 IA Ib#YPIIi'I- Erid ACD L�•••.Ilareatie•ITn .... ....••• DrCllr'r8ti�GJ.0 R ...,. .0 .0. 18 Suspended 03/03/2009 10/05/2014 D53 Non -Payment of Iowa Fine IA IA Suspended 03/03/2009 07/08/2013 D53 Non -Payment of Iowa Fine IA IA Suspended 06/12/2009 09/08/2009 W01 Habitual Violator IA IA Suspended 08/27/2009 10/21/2014 D53 Fall to Satisfy Non -Iowa Citation PA IA Suspended 08/27/2009 01/21/2014 D53 Fall to Satisfy Non -Iowa Citation PA IA Suspended 08/27/2009 01/21/2014 D53 Fail to Satisfy Non -Iowa Citation PA IA Suspended...............0.1,/2,0/2010 10/05/2014 D53 Non -Payment of Iowa Fine IA IA 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: b..........2v 11/12/2014 IOWA D. 0. T Pe' t Office of Driver Services Iowa Department of Transportation Name: Peterson, Cheryl June DL/ID: 556YY1175