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Home My WebLink About14-256It IIIisy + MYI°°r�� CITY OF IOWA CITY 410 East Washington Street Iowa Cit 10 52240-1826 (31 5040 (319) 35 5497 FAX Authorization Number /V- a.5L.) (Ottice 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.) Failure to complete the "required" information will resuft in denial of the application 1. Name (REQUIRED) First (3cvau Middle Last_ bumv 2. Mailing Address (REQUIRED) '705 1$4 Ay6 u,4 3. Contact Information (REQUIRED) Email: Tb ZZ -c2 ?qq oo, C6" Cell Phone: 3(q. Cot, t377 4. Prior experience in transportation of passengers: _k)N04L 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? loc) Type of offense Where When �No e` zao/- 4� 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? pia Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When 8. Has your drivers license or chauffeur's license been suspended or revoked in the last five years? c5 Type of offense Where When U R fr'Nl1 Ca K 64n lGe 2 0 13 . 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please prov jhefiame(s� r.a tZ, -� V DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF`REWEW You must apply for an individual Department of Criminal Investigation Report (form available uport eequest). (OVER FOR REQUIRED SIGNATURE AND NOTARY) 09/2014 I hereby certiify, that li have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number %S(YY `♦ �l . 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. (Needs to be signed in front of a Notary Public) Signature of Applicant _ Date k 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 ) Sybscribed and sworn to before me by I fLA_Q� -1 On this �+ day of — �� ';�i , KELLIE K.TUTTLE '� �r t— )� 0 H_ tuber 22tsfs Notary Public in and for the State of Iowa 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'nfPdIce 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. Sign re of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 %" (width) and 5 Y:" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update Cllr rAXIDR BADGa.PPL0201aarnenddd.DOC 0912014 Nov. 14. 2014 ■■ '.Yu v, I L. LV 14 1 13 P 11111 C[ Ivrof1eCraimi�,IIIYIuylesIUWld bIUly Nv-) i54 PP.4l/3 I ILInYI STATE OF MWA CrAynling] History Rec®yd Check ][bequest Fon n To: Iowa 33MAi011 of Criminal lnvestigailon Support Operations Bureau, P, Floor 215 E. 7.n Street IDes Moines, Towa 50319 (515) 925-6066 (515) 725.6090 Pax T 'e uestln an Iowa Criminal Histol Record Check on DCI Account Number: q (iPoppl cable Prom; City of Iowa City City Clerk's Office 410 Pb. Washington Street IOW3 City, IA 52240 Phone: 319-3365041 Faxl 319-3566497 amt Last Name asndato First Name mandator 8f qrl Middle Name (,-a--,= 1) pUNfJ -T Date of Birth (manamory) Gender (mandatory) Social Security Number (ownimeadca) 'g- Zl • M? C'IATaIe O etttale 3 $o ou 58 37 Waiver Irt/ormallon. Without a signed waiver from lhosublect of the request, a complete criminal history record may not be releasable, per Code of Towa, Chapter 69221 For comp criminal history record Information, as allowed by law, always obtain a waiver el naturofrom rho aab eat of the re oast, walwy 1e1ease: 1AM66y give permission fordm abovercgacsung orrdat to conduct an Iowa criminal historyrewrd check with the Division ofCdn final hlvevigatlon(DCO. Any aiminal history data wnumiugmerhat!s rnaintaluedby Ilia DCl may he released as allowed by law. ky " l I Waiver§iguature: Iowa Criminal History Record Check R ults 't As of a search of the provided natne and date of birth hevealed, ❑ No Iowa Criminal history Iteco)d found with DCI r^' 4�1 Iowa Criminal History Record attached, DCI # / DCIinitials--)� V Received Time7Nov.12.1,2014 1:17PM No. 5041 Nov.14. 2014 4:14PV1 Div of Crircioal Investigation DCI :00671169 NAME: DUNN,BRYAN J DOB SEX 19780621 M IOWA CRIMINAL M18TORY MISDEMEANOR CONVICTYONS ONLY DCI 00671169 PAGE 1 OF 2 DATE PRINTED - 2014/11/14 RAC HOT WGT EYE HASR 15 KN POB B 601 155 BRO BLK MI ADDITIONAL IDENTIFIERS TAT LF ARM CCH RECORD "' 01 ARRESTED 20020525 AGENCY? IA0920100 WASHINGTON PD CHARGE NO- 01 IA STATUTE IA708-1-1 SERIOUS ASSAULT TRK#: 05543/901 COURT DISPOSITION AGENCY: IA092015J WASHINGTON CO DIST COURT COUNT NO- 01 IA STATUTE IA708.2(5) ASSAULT COURT CASE ID: 08921 SRIN006617 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#; 055431901 SENTENCE TIME SERVED 1513 JAIL 15D 02 ARRESTED 20030717 AGENCY: IA0570100 CEDAR RAPIDS PD CHARGE NO- 01 IA STATUTE IA321-560 DRIVING WHILE BARRED TRK#: 502165601 COURT DISPOSITION AGENCY: IA057015J LINN CO DIST COURT COUNT 90- 01 IA STATUTE SA321.561 DRIVING WHILE BARRED HABITUAL OFFENDER COURT CASE ID: 06571 AGCRO51930 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 502165601 SENTENCE BINE $500 03 ARRESTED 20060226 DISP EFF DAT 20021204 20021204 DISP EFF DAT 20030730 AGENCY: IA0570100 CEDAR RAPIDS Pb CHARGE NO- 01 IA STATUTE IA321J.2(2)(A) OWI/1ST OFFENSE TRK#: 503470501 COURT DISPOSITION AGENCY; IA057015J LINN CO DIST COURT COUNT NO- 01 IA STATUTE IA3210r.2(A) OPER VES WE INT (OWI) / IST OFFENSE No.5254 P. 2/3 Nov.14. 2014 4:14PM Div of Criminal Investigation COURT CASE ID: 06571 OWCR065835 CHARGE CLASS: MISDEMEANOR CONVICTION TRKO: 503470501 DRUNK DRIVING SCHOOL SENTENCE TIME SERVED FINE $1000 JAIL 7D COURT DISPOSITION AGENCY: IA057015.1 LINN CO DIST COURT COUNT NO- 03 IA STATUTE IA719,1(1)A INTERFERENCE WITH OFFICIAL ACTS COURT CASE ID: 06571 OWCR065835 CHARGE CLASS: MISDEMEANOR CONVTCTIOW TRK#: 503470503 SENTENCE FINE $250 DCT, 00671169 PAGE 2 OF 2 DZSP FFV DAT 20060802 20060802 20060915 DISP EFF DAT 20060802 AN ARREST WITHOUT DISPOSITION IS NOT All INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION I$ A PUBLIC RECORD BUT CAN ONLY HE RELEASED TO NON -LAW ENFORCEMENT AGENCIES BY TIM 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 525A P, 3/3 ,�410WADGT .1 wV'JL'i/,iowadot. gov SfliA ?TER [ SiIF)ki:r,. 3 CUSTOif: l'. t ,Rikv' l 07nice of Dxrrer SRrvices PO Bo,r 9204 ` re- F, ands. 6A Efl302-22P4 Ph,j,,a. 6I5 -244-91x4 1800-632-1121 [Fax: 5•15 -23r, -i E37 wviw..to Nadot.gov Inquiry Date: Name: Address: City/State: Mailing Address: 11/20/2014 Dunn, Bryan I 744 E 2ND ST WASHINGTON, IA 523532216 744 E 2ND ST Mailing City/State: WASHINGTON, IA 523532216 Convictions Certified Abstract of Driving Record DL/ID #: 781'(Y4818 (IA) Class: D Audit #: 8300376 Issue Date: 07/29/2014 Expiration 08/21/2018 Date: Endorsements: 3 Restrictions: NONE Date of Birth: 8/21/1978 Sex: M History Information Customer #: 5035817 ID Status: VAL DL Status: VAL CDL Status: None CDL Cert None Status: CDL Med None Status: Restriction None Supplement: c itstlon a ii e Conviction Date ACD Bx.4lanaFion Cou S.q?, lU 08/23/2012 _ - 69/26/2010122 - F04 Seat Belt Violation Johnson - IA ' 01/27/2014 04/02/2014 Improper Registration Soh risen IA ' - 01/29/2014 03/11/2014 Improper RegistrationJ.oYhnson: Non Payment of Iowa Fine IA=� 03/05/2014 04/02/2014 M14 -Fail to Obey Traffic Sign/Signal _'"'dohnsW— IA operating While Intoxicated Test Refusal/Test Failure Violations Gcrurrenee Ac�,1 �xplanat€en .'= 7Yii 02/26/2006 .Al2 OWI Test Refusal IA - Sanctions Sanctions Type Ztysetuz Red ACD Exglana'aon occurrence Jur, 733: Revoked 03/09/2006 03/08/2007 Al2 OWI Test Refusal _IA IA Suspended 01/01/2013 01/06/2013 D53 Non Payment of Iowa Fine IA _ IA _ Suspended 06/18/2014 07/23/2014 -D53 Non -Payment of Iowa Fine IA IA Name: Dunn, Bryan 3 DL/ID: 781YY4818 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.