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Home My WebLink About14-2521 r i CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 3S6-SO40 (319) 356-5497 FAX 1. Name (REQUIRED) Authorization Number 1y -a& -i (Office Use Only) APPLICATION FOR TAXI I 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 result in denial of the application A- 2. 2. Mailing Address (REQUIRED) €3o 3. Contact Information (REQUIRED) Email: 4. Prior experience in transportation of passengers: Eco--, -t>A- lwjcJ, C, c2 -,j �Da Phone: 5�'� 3-t-:6 1E c-,) 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 'I k�-,;, Type of offense When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? (� O Tvpe of Offense Where 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where 380 When When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? Tvpe 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 STATEElITIFIED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CAP:RE1 tW Cl 1 You must apply for an individual Department of Criminal Investigation Report (form availabtQlpoH�equa"sT- RrY] (OVER FOR REQUIRED SIGNATURE AND NOTARY) - 0912014 I hereby cerci that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number r7� C� �� 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 ti pas with all of the provisions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) ' 1 Signature of Applicant 'J Date \ ` L Z' YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERKS OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by St,,,, ��j S. F C b On this /qt -A, day of 1N ) r,.12 uA� Public in c,mmisswon Expires 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). Signa Chief or designee t�/ ate 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. $ign�ature of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 %" (width) and 5'/2" (height) and prominently displayed to all passengers. Office Use Only Approved application DCI report State certified driving record Website update Clerk AxiDRmeADGe PPL9014emerdeaooc 0912014 Iowa Department of Transportation p� C1lfireofunverSrrvicl (loll Free) al)&532-1121 PC) BOX 9204, Fits Manu to 50M-11-1264 515-2414-9j24 FIAX 51 5- 219 1337 Convictions Citation Date Certified Abstract of Driving Record ACD Inquiry Date: 11/7/2014 DL/ID #: 555xx5019(IA) Customer #: 3919725 Name: Erb, Stuart John Class: D ID Status: EXP Address: 1040 N GOVERNOR Audit #: 7394299 DL Status: VAL ST UNIT A Issue Date: 10/01/2013 CDL Status: None City/State: IOWA CITY, IA Expiration Date: 10/08/2018 CDL Cert Status: None 522455922 Endorsements: 3 CDL Med Status: None Mailing Address: 1040 N GOVERNOR Restrictions: NONE Restriction None ST UNIT A Supplement: Date of Birth: 10/8/1986 Mailing IOWA CIN, IA Sex: M City/State: 522455922 History Information Convictions Citation Date ACD ACD Ex lanation Coun ]UR 12/17/2006 f04tJ091t200t7l Revoked 20 Deferred ]udgment OWI Johnson IA Operating While Intoxicated Test Refusal/Test Failure Violations Occuranca ACD Explanation JUR 12/17/2006 A98 OWI Test Failure IA Sanctions Type Effective End ACD Explanation Occurrence ]UR ]UR Revoked 112/28/2006 106/2512007 IA98 OWITest Failure IA 4k..' Name: Erb, Stuart John DL/ID: 555xx5019 i_0 Pursuant to Iowa Cade §321.10, I, Kim Snook, Director of Office of Driver Services, Iowa DepartM41d't of T.ransporkat", do hereby certify that I am the custodian of the records held by the Office of Driver Services, that this isA 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 Idwa 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: Name: Erb, Stuart Ichn DL/ID: 555xx5019 a�jFIGfF 4M 11/7/2014 IOWA 1MO D 0. 1..' rRI�E�+ office of Driver Services Iowa Department of Transporation 1. Div of Crlm'inal lnvestlgatlon (FAx)3ts3� 11/NOV. 12. 2U43; 2l23PMCab _ STA rrz OF IOWA Check Criminal history Record -Request k'orm 9967-F—� DCL AcoountNumber; orwiloab(a) Fpm; yellow Cab of Iowa Cit P.O. Box 428 TO, Iowa Divielonofcriminal In eo sglooirn 87844 Support operations Durcau,. Iowa Cityr • ,ISE I* street 5031(314) 388.4777 Des Moines.. 9 phones (515) f25-fi0fi6 (319)339.7307- ($15) 725-6080 Fax Farcm Jddle Nit �commonded low& Criminal Sisto Record Chace da,o lamra uasdn a F1rstNatn t Joi-iN Leet p]airte lme„Jsrory) 1S-T V WT sootal Baotlri Number reaoInmonde Gander,(�nd�a°rr) l�- Date of Birth mandato 1 �jMale overaille r&oerd may not C(8 (p �+ uo9t; a complel& arlminal llow0 TAW, &lwaye (� ` (]g record sntormnationr as allowod by without a alFad waterer from the subject of the req armation: W For •� orlminal hletory. yyaJvmtr7t�• Chapter uesL riminel be roloneablo, Per Code of lows, social to oanduol an Iowa criminal Blalbry racord c&aekwld+ the plvlslon or oblainawaiverelnalurafromthesubectofthere eerawued allowedbylaw. ucpingo ;fiapClmrY Ova permlfdan Ibr Ih'sbnla �a41+maintained by Waiver Release: t hereby tmeaflgellon(Dch. AAY odminal h+narY dOta eo j�AtVer SlgilatGrBm (pClucearty) d 'sfo RecorCl1eckRegu IOWA (,"ri1r1a and data o£bir ievealed: rf a search of the Provided nam pa of rY Pwoord found with DCL ;. ❑ No Iowa Criminal Hl&to Record attached,'DCI Iowa climiral History r— DCI inldals DC1-77 (08125110) T'Ime Nov. 5 2014 4:36PM No.4622 Nov, 12. 2014 2 : 2 3 P M DCI:00792126 NAME: ERB,STUART JOHN DOB SEX RAC 19861008 M W D l v of CrlminaI I n v e s t l g a t l o n IOWA CRIMINAL HISTORY DCI 00792126 NON CONVICTION PAGE 1 OF 2 DATE PRINTED - 2014/11/12 HOT WGT EYE HAIR SKN POB 600 230 BLU BRO FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED 20061217 AGENCY: TA0520100 CORALVILLE PD CHAROR NO- 01 IA STATUTE IA321J.2(A) OPER VSH WH TNT (OWT) / IST OFF TRK#: SA000GZ01 CHARGE NO- 02 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE TRK#: 1A000GZ02 COURT DISPOSITION AGENCY. IA052015J JOHNSON CO DIST COURT COUNT 110- 01 IA STATUTE IA321J.2(A) OPER VLH WH INT (OWI) / 1ST OFF COURT CASE ID: 06521 OWCRO78161 CHARGE CLASS: NON CONVICTION TRK#: IAOUOG7,U1 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE DEFERRED JUDGEMENT PROBATION IY UNSUPERVISED UNDER DOC COMMUNITY SERVICE 50H DISCHARGED FROM DEFERRED JUDGEMENT COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 TA STATUTE IAI24.401(5) POSSESSION OF A CONTROLLED SUBOTANCP COURT CASE ID: 06521 OWCR078161 CHARGE CLASS: NON CONVICTION TRK#: 1A000GZ02 DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION SENTENCE DEFERRED JUDGEMENT PROBATION lY UNSUPERVISED UNDER DOC COMMUNITY SERVICE SON DISCHARGED FROM DEF�ER�RED JUDGEMENT pa/t- /'" No. 3B48 DISP EFF DAT APPEAL DATE 20070409 20070409 20071101 20070409 20071109 DISP EFF DAT APPEAL DATE 20070409 20070409 20071101 20070409 20071109 moi•' 1 No v. 12, 2014 2; 23 PM Div of Criminal Investigation DCI 00792126 PACE 2 OF 2 AN ARREST WITHOUT P18POSITION 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. 3848 P. 3/3