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Home My WebLink About15-011Authorization Number ---Lei 1 t (Office Use Only) w OF IOWA ) APPLICATION FOR TAXI / MOTORIZED PEDICAB VEHICLE DRIVER CITY(Police Department review must be made between 8 a.m. to 3 p.m., Monday— Frlday.) 410 East Washington Street Iowa Cid, wa 52240-1826c'�C�dRY_$CY..Com letP'-..".-.'..`..Traci/'�'�t°'i7ytPJSTntfR..'an,Lw6(I fe52aft iBt tVeW@9al cYf lCP9"a1.7�gdA�tY'®M,YP i5 56 497 FAX ..._... _......_........................._.............._..... x'1.319) 356-5040 ',� �T9) Fi{t Middle Last 1. Name (REQUIRED) t a� 2. Mailing Address (REQUIRED) igJ �' e"44 �1? Cha Oaf 3. Contact Information (REQUIRED) Email: 'Lx Elm 1�&"� Cell Phone: yc° ... 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 7voe of offense Where rur C'�.dxta t �JcSia�a d'% ✓��R �� 1G7 /, J s'P fm 9b'm` l g�ppn C %,u"�6YlY�h./ ^w.F m.,�m#✓ro R'.n. � P...^NsPn.; & 1 �F%RI °�! -^. 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? IV _ 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? N 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 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) 09/2014 I hereb ce�ify tli have issued to me by the !owa Department of Transportation a valid Chauffeur's license number V t� 1� j C2 . I understand that if I falsely answer 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 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. (Nerds to he signed €e from' of a Notary Public) 7 p yr Signature of Applicant /L. Date 112 A�% YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA C 4 UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city website at !rgov.crg. STATE OF IOWA ) COUNTYOFJOHNSON ) Subscribed and sworn to before me by 12,4nvjj?-,C ':2V1 V1b) l ti On this day of 4 -. le" 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). Signature°' f�F'blice Chief or designee 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 bf•Gity Clerk or designee ® ( / //I-, I-. Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8'/2" (width) and 5'/2" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update CIr2?AYJDRNBADGEAPPL92014am ded.DOC 09/2014 4 W �h 1 q tgrylt P1 gm�pygpg)pyp iowado . v SMARTER fl SIMPLER � Wn UYA94,dµ�v:�fl" DMEM N„.N pWPopµMIPo9WpINN19m➢RwY41GV°u....l:..}o'i��i Kfd:9gnNRR Office of nrivar Aa Wcee PO W10x.92I4fl : Da Y9t nes, w, Sf.P •0A Y9 _5'tl5-24'4.02A Q.9fi0^ 9'%-BR":.'N a Fv, 39'&R.4.k7 wrWWJnwr2gWLgg0v CAm•EMed AbStnact of III TIviiin @ urd In0uiry Datea 12/3/2014 DWID ama 439VV6230 (IA) Nome= Connolly, Robert Raymond Jr Cheese C Addroodn 21 Second St Apt 2 Audit Da 8638618 None Iftswelian Isonom Deaaa 12/02/2014 aty/WeRen. Hofs, IA 52235 Effidradon DUSIC 12/04/2018 IA, IA Endornmenade NONE MWHng Addreses PO EOM 7 Reshrklionas Camexthre Lenses IA Revoked12/09/2009 onto of Binh. 12/411959 NWing Cftyldlsolod HILLS, IA 522350007 Skeug N DalU W, M'bllnrrVcf.lan @,Yw% ACO 4f^,Allman efloll6 28 U2jcmw2DWV1'•N A20 operelan0 P9iNIhliVal Raanvx0cah;ra e9 OW -21V7.011. A20 IX PSMWl g WhOo YnWxaxNxTAd I occurnnmcae ACD EW444asumetWn Doll 1,12,01M A98 OW! 'tt'oetW'aWlUule 0 AW9/a"?= 198 Owl "rLat Ware i cuodamer do 2681075 ZO Stman None DL Sent= WEAL CDL Staturso None COIL Cert ellum None COL Had Statung None Iftswelian Nene Suppkmwwb 10.(12/2008 County ,MAR jorehnson I% .II¢uhlefmrerl 1A. 1UP. IA IA Type EffMcffive Pad ACD ExppanafYoem OMMIrronce 1UR 3UR Revoked 09/22/2008 03M2009 A98 OM Test FROure IA IA Dbequalffied 10.(12/2008 IOJ1o12009 A98 Owl Tut Fallum IA, IA Suspended 12/05/2009 1210! 11 863 Faff to Reflls SR22 IA IA Revoked12/09/2009 lZm3i2olD AN OW Task Falure IA IA Suspended OBJDf/207.1 DIJ30MI2 D27 fa an of Probation IA IA Suspended IQM312013 1111' 13 D53 Noe -Payment df Iovta Fine IA IA Suspended X"12013 ._m WWW2 D53 NOR'Sayment of Iowa Hoe IA IA Pursuant to laws owe 6321.10, 1, lam Snardo Director or Offim of Orwarse"I il'. f l in Witness Whereof, I have mused my allBy.i i A / OfflCe of DrIver loadiDepartmentafTmnspormon Jan, 9. 2015.10:24AM Div of Criminal Investigation No.7666 P. 2/7 Jd 11. /. ZVI) J:4JrM l,lty blerk — 6ity of Iowa city No. 5520 P. 2/2 Tog Iowa 'Dtvidou4oft6elsta9mwq:Knn� Suppark 6tpormttorua Bumaeu, llrF600m ms F. Ina stttet If Du Monwuman I'oava 46'319 (q:95) 725-60666 (11S) 725.6080 PAZ um .ld wra 01minal T1astorv]R000vd Check ouar l�Q�oo®N�r9$4�tSn'q'LP7ea t�t�rpNBcabNe� mat •„1t� o6.IIo apt,„_ city ctepWo War's ,.. �A6 �. aettpao6ttDua �tyeot ...,�. An Cptys._M 52X46 rhoamet 319zS6.4961 I FOX3 $19-316 94.97 WaiverAqformefion w#qhoutaalRttamwaivertrowaotheiobjeetoftholregmrcat,ar"ommpletoculinaguapIthtovyreeordmanyNot fiea°eteaaabte,per Ode dlomva,Maga 6..917,:lyor.Fjw�n_9Let_asmlmmInAh1atoryIreeordlInfor atiozn,asatpoarredtroy14%Alwaya Wadva'deffsm1hoseby6vapcaetllsaronfortoasevosr.4uuudngofflow¢owaadartamraWAaarAG9biikiewpocouaAecewtth&aDIASionetcrtmMoll rnt+estug;ettaKp �r9dy, BA hrn[oey dak mumkg nap, that Is oumtabliumd lb.y Aw lmmpybo re psed as ofiawr..d by laww" tor i Record Check Results Iowa Criminal -fi$I�® mvdedYime uddate a�irth t°6wrora6�de tnciureonl» Aa u:f.....................I ^ — P ro , No IP,atliPa C.Yhinal Mstory Re ouoyd Lo d wuth'DU lova Criminal. History Ilec rd attookaad, DC.r # a2 5 .•j Received Time—. 2015— 3�41PIt�—No.. 75.3:3 Jan. 9. 2015 10:25AM D,v of Criminal Investigation ADDITIONAL IDENTIFIERS SC HEAD TAT CREST TAT UL ARM TAT UR ARM PHOTO AVA'ILABLY4; Y CCH RECORD #*& AGENCY: ZA0520000 JOHNSON CO SO CHARGE N0- 01 IA STATUTE IA700-6 INTIMIDATION W/DANGEROVH WEAPON TRK#: 101066501 COURT DIS O91TION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA700.6-2 INTIMIDATION WITH A DANGEROUS PMAPON COURT CASE ID; 06521 FE 076027 CHARGE CLASS: FELONY CONVICTION TRK#7 101066501 SENTENCE DISP EFF DAT DEFERRED JUD04MBUT $750 CIVIL PENALTY 20070914 PROBATION 2Y 20090914 SUPERVISED PROBATION TO DCS DINE IOWA CRIMINAL HISTORY SUSPENDED PRISON 20090213 PRISON 20090213 PROBATION UPON DCI 00776527 DEFERRED JUDGMENT FELONY CONVICTION REVOKED IMPOSED 5Y PAGE 1 OF 3 DATE PRINTED - 2015/01/09 DCI: ,00776.52'2 NAME: CONNOLLY,kOBBRT RAYMOND CONNOLLY,ROBSItT RAYMOND JR D08 SEX RAC HGT WGT nl4x HAIR SKM pOH 19591204 M W 509 172 ALU BRO NJ ADDITIONAL IDENTIFIERS SC HEAD TAT CREST TAT UL ARM TAT UR ARM PHOTO AVA'ILABLY4; Y CCH RECORD #*& AGENCY: ZA0520000 JOHNSON CO SO CHARGE N0- 01 IA STATUTE IA700-6 INTIMIDATION W/DANGEROVH WEAPON TRK#: 101066501 COURT DIS O91TION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA700.6-2 INTIMIDATION WITH A DANGEROUS PMAPON COURT CASE ID; 06521 FE 076027 CHARGE CLASS: FELONY CONVICTION TRK#7 101066501 SENTENCE DISP EFF DAT DEFERRED JUD04MBUT $750 CIVIL PENALTY 20070914 PROBATION 2Y 20090914 SUPERVISED PROBATION TO DCS DINE 20090213 SUSPENDED PRISON 20090213 PRISON 20090213 PROBATION UPON 20090213 REVOCATION OF DEFERRED JUDGMENT REVOKED IMPOSED 5Y $750 20090213 'SY' 20090213 5Y 20090213 3Y 20090213 AGENCY; 0520200 'IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J.2(A) OPEN VEH WH INT (OWI) / IST OFF TRK#: IA0053NOI COURT DIBPOEIT:ICON AGENCYP IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA321J.2(A) OPER VER 19T. (OWI) / IST OFF COURT CASE ID: 06521 OWCROB4600 CHARGE CLASS: MISDEMEANOR CONVICTION TRK'#;; 2.AO053'NOI IN No. 7666 P. 3/7 Jan. 9. 2015 10:25AM D v of Criminal Investigation OCT 00776527 PAGE 2 OF 3 DRUNK DRIVING SCHOOL DISP EFF DAT SUBSTANCE ABUSE EVALUATION $750 RESTITUTION SUSPENDED FINE $750 SENTENCE PRISON DISP BFF DAT SUSPENDED JAIL 173D 20090205 JAIL, 1ROD 20090205 FINE $1250 20090205 PROBATION 2Y 20090205 IMPOSED 173D 200.91.201 REVOKED 20091201 03 ARRESTED 20090909 RESTITUTION AGENCY: IA0520200 IOWA CITY PD SENTENCE CHARGE NO— 01 YA STATUTE IA716.3 FINE CRIMINAL MISCHIEF IST DHO$ffiE — 1970 SUSPENDED FINE TRK#: 1A0070M0I 20110628 PRISON CHARGE NO- 02 IA STATUTE IA708.4(2) WILLFUL INJURY - CAUSING BODILY INJURY TRK#: 1A007OM02 CHARGE NO- 09 IA STATUTE :FA327.J..2(E) OPER VER WH TNT (OWI) / END OFF TRK#e 1A0070M04 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA'716.3 CRIMINAL NY$CHIRP 2ND DEGREE - 1978 COURT CASE ID; 06521 FECRO08338 CHARGE CLASSw FELONY CONVICTION TRK#: IA0070M0I RESTITUTION SENTENCE DISP EFF DAT FINE $750 20110628 SUSPENDED FINE $750 20110628 PRISON 5Y 20110628 COURT DISPOSITION AGENCY: IA052015,7 JOHNSON CO DIST COURT COUNT NO— 02 IA STATUTE IA708.2(1) ASSAULT INTENT TO INFLICT SERIOUS INJURY -1970 COURT CASE ID: 06521 PECRO88338 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: IA0070NO2 RESTITUTION SENTENCE DISP RVer DAT FINE ,$625 20110628 SUSPENDED FINE $625 20110628 PRISON 2Y 20110620 No, 7666 P. 4/7 jan. 9. 2015 10:25AM Div of Cr minal Investigation COURT DISPOSITION AGENCY: YA0520155 JOHNSON CO DIST COURT COUNT NO- 04 IA STATUTE :r.A32IJ, 2(a) OPER VEE WR INT (OWI) / 2ND OFF COURT CASE IDA 06.521.. PPCR0063.38 CHARGE CUM MISDEMEANOR CONVICTION TRCC(p: 1A007OM04 LICENSE REVOKED RESTITUTION SENTENCE J'AII.: 6m FINE $1075 MaHrt :..�r.�„. CHAR09 No- 01 IA STATUTE IA690,4 CUSTODY IOWADEPT 4,€ CORRECTIONS TRK#! CBOOC4001 INNATE #; 6793503 CUSTODY AGENCY: IA077015G ADULT PAROLE SVC A 20120425 PAROLED CUSTODY AGENCY: IA0770150 ADULT PAROLE SVC S 20130407 DIScr4ARGr,D DCI 00776527 GAGE 3 OF :3 DISP EFF DAT 20110620 201106'29 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 WON -LAW ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR posITZV3 IDENTIpICATIONTHIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SURCUCT OF YOUR YNQulm DIVISION OF CRIMINAL INVESTIGATION ` , No.7666 P. 5/7