HomeMy WebLinkAbout2007-11-05 Appointment
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NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
AIRPORT ZONING BOARD OF ADJUSTMENT
One vacancy - Unexpired + 5-yr Term
Ending December 31,2011
The powers and duties of the Airport Zoning Board of Adjustment are:
1. To hear and decide appeals where it is alleged there is an error in any order, requirement,
decision, or determination made by an administrative official in the enforcement of the Airport
Zoning Chapter.
2. To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which
such board is required to pass under the Airport Zoning Chapter.
3. To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning
Chapter as will not be contrary to the public interest, where owing to special conditions a literal
enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship,
and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of
Iowa City. The Board meets at the call of the Chairperson.
Applications must be received by 5:00 p.m., Wednesday, October 31, 2007. The City Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application
forms are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be
directed to Michael Tharp, Airport Operations Specialist at 356-5045.
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in-
law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step-
child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 0
Council Announcement Date: June 13, 2006; August 1, 2006; September 5, 2006;
September 19, 2006; November 14, 2006; December 12,
2006; January 9, 2007; February 20, 2007; March 20, 2007;
May 1, 2007; June 5, 2007; July 24, 2007; September 18,
2007
Application Deadline: Wednesday, 5:00p.m., October 31,2007
Council Appointment Date: November 5, 2007
AIRPORT ZONING BOARD OF ADJUSTMENT
One Vacancy - Unexpired + 5-yr Term
Ending December 31, 2011
Carl Williams resigned
No Applications as of Wednesday, 5:00p.m., October 31,2007
[R] Denotes applicant completed the Confidential page of the application.
l'14; J
NOTICE
THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING BOARD:
AIRPORT ZONING COMMISSION
One vacancy - Six-yr Term
January 1, 2006 - December 31, 2011
Duties of the Airport Zoning Commission are:
1. To recommend amendments to the current Iowa City Airport Zoning regulations, including the
repeal thereof.
2. To recommend the adoption of new Airport Zoning regulations.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of
Iowa City. The Board meets as required.
Applications must be received by 5:00 p.m., Wednesday, October 31,2007. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application
forms are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Airport Zoning Commission should be directed to Michael Tharp,
Airport Operations Specialist at 356-5045.
Spouses and relatives of City Council Members and members of comparable County
Boards and Commissions are not eligible for appointment to City Boards and
Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in-
law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step-
child, aunt, or uncle. (Resolution 85-354)
Males: 4
Females: 0
Council Announcement Date: September 20, 2005; November 1, 2005; December 13,
2005; January 23, 2006; February 28, 2006; March 21,
2006; April 18, 2006; June 13, 2006; August 1, 2006;
September 5,2006; September 19, 2006; November 14,
2006; December 12, 2006; January 9,2007; February 20,
2007; March 20, 2007; May 1, 2007; June 5, 2007; July 24,
2007; September 18, 2007
Application Deadline: Wednesday, 5:00p.m., October 31,2007
Council Appointment Date: November 5, 2007
AIRPORT ZONING COMMISSION
One Vacancy - Six-year Term
January 1, 2006 - December 31, 2011
Term expires for Mark Anderson
No Applications as of Wednesday, 5:00p.m., October 31,2007
[R] Denotes applicant completed the Confidential page of the application.
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NOTICE
THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING BOARD:
BOARD OF APPEALS
Two Vacancies - Five-Year Terms
January 1, 2008 - December 31, 2012
One (1) Home Builders Association Representative
One (1) Licensed Plumber
It is the duty of members of the Board of Appeals to hold appeal hearings on matters concerning the
Uniform Building Code, Uniform Plumbing Code, National Electric Code, Uniform Mechanical Code,
Uniform Fire Code, the Dangerous Building Code, and the Iowa City Housing Code. Members must be
qualified by experience and training to pass upon matters pertaining to building construction.
Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa
City. The Board meets the first Monday of each month at 4:30 p.m. or at the call of the Building Official.
Applications must be received by 5:00 p.m., Wednesday, October 31, 2007. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions regarding the Board of Appeals should be directed to Tim Hennes, Sr Building Inspector at
356-5122.
NAME
Gary Haman
Steve Buckman
Doug DuCharme
Tim Fehr
John Roffman
Chad Campion
AI Gerard
KEY
X = present
o = absent
OlE = absent/excused
NM = No meeting
_ = not a member
TERM EXPIRES
12/31/2007
12/31/2011
12/31/2009
12/31/2008
12/31/2007
12/31/2008
12/31/2010
May-07 Jun-07 Jul-07
NM x x
x x
0 x
x OlE
x x
x x
X x
Board of Ipp~@I~
Attendance Record
2006
Jan-07
x
Mar-07
x
x
OlE
OlE
x
x
x
x
x
x
x
o
x
Feb-07
x
x
x
x
x
o
x
Board of Appeals
Attendance Record
2006
Aug-07 Sep-07 Oet-07 Nav-07 Dee-07
x
x
o
x
x
x
x
Apr-07
NM
Spouses and relatives of City Council Members and members of comparable
County Boards and Commissions are not eligible for appointment to City Boards
and Commissions. This includes: spouse, child, mother, father, mother- in-law,
father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-
mother, step-child, aunt, or uncle. (Resolution 85-354)
Males: 4
Females: 0
Council Announcement Date: September 18, 2007
Application Deadline: Wednesday, 5:00 p.m., October 31,2007
Council Appointment Date: November 5,2007
BOARD OF APPEALS
Two vacancies - Five Year Terms
January 1, 2008 - December 31,2012
(1) Homebuilders Association Representative
(1) Licensed Plumber
Term expires for John Roffman, Gary Haman
(1) Homebuilders Association Representative
John Roffman
1314 Burry Dr
[8]
(Currently serving 4th 5-yr term)
(1) Licensed Plumber
No Applications as of Wednesday, 5:00p.m., October 31,2007
[8] Denotes applicant completed the Confidential page of the application.
City of Iowa City
Advisory Board/Commission/Committee
Appli,cation Form
1 ~ 1
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CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on
matters of interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Advisory Board/Commission/Committee Name "'B6A~?:t::> of APPE-lJL b Term 5 y rS.
Youth Advisory Commission, Age on the date offiling:D Age 15 to 17 (or) D Age 18 to 21
Signature of parent/guardian if Age 15 to 17:
lAME JDf4 r0
~ F FM tPc..,J
('3 \4- BURRI(
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ZIP o~~ Lf ('.p
!Xl Yes D No
HOME ADDRESS
"Is your home address (listed above) within the corporate limits of Iowa City?
How long have you been a resident of Iowa City? 3 ~ Y r '5,
OCCUPATION C()~If"PQ.1"i)t:. EMPLOYER CSc/"F"
PHONE NUMBER: HOME 35 1- 31 t..J I BUSINESS 35/- 3[ '-l ,
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
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floMEBtltl b.E~
~o YE~
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Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2006 "
Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
f/,IJ-tIE 0t5RtJE b
l./ Fu~L T/S/U)Jb elf) We BAiteD
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
35 ~MRS. t=:.xPEie.IEPCE /IV &Slll/tZ~; EXPEme,VCf" dA/
rife &/J-,e b;' LJtul/.J /2e:.A.JTAt- P"r:;o;OE/27Y
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POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests, including financial interests and your duties to an employer.
In particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030. "
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? fZl Yes D No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMIS'SION? D Yes ~NO
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING"
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CITY OF IOWA CITY
Name of City
Board/Commission/Committee fu~ CJF /Jpf)8l}t ~
Name JeUtJ ~F~M-j),J
Date 10-1-07
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate if there are none.
~~~<lG,
~~
\ 11
--r;
.c-~ l'0
)>
NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature
Signature of parent/gu
Address 3
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2006
Page 3 of 7
c;:J
NOTICE
THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING COMMISSION:
SENIOR CENTER COMMISSION
Two Vacancies - Three-Year Terms
January 1,2008 - December 31,2010
The duties of members of the Senior Center Commission are to:
1. Serve in an advisory role to the City Council with regard to needs of the Senior Center.
2. Make recommendations with regard to policies and programs at the Senior Center.
3. Join staff and other interested persons in seeking adequate financial resources for operation of the
Senior Center.
4. Encourage full participation by senior citizens in the programs of the Senior Center.
5. Ensure that the Senior Center is effectively integrated into the community and cooperates with
organizations with common goals in meeting the needs of senior citizens.
6. Serves in an advocacy role with regard to the needs of senior citizens in Iowa City.
Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa
City. The Senior Center Commission meets the third Tuesday of each month at 3:00 p.m.
Applications must be received by 5:00 p.m., Wednesday, October 31, 2007. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Senior Center Commission should be directed to Linda Kopping, Senior
Center Coordinator at 356-5225.
151 Draft
September 2007
Senior Center Commission
Attendance Record
Year 2007
Name Term 1/16 2/20 3/19 4/17 6/19 7/17 8/21 9/21
Expires
Bob Engel 12/3 1/08 X X OlE X X X X X
David Gould 12/3 1/08 X X X OlE OlE X X OlE
Chuck Felling 12/31/09 NIA NIA X X X X X OlE
Jay Honohan 12/31/07 X X X X OlE X X X
Betty Kelly 12/31/07 X X X X X X X X
Sarah Maier 12/31/06 X X X X X X X X
Nancy Wombacher 12/3 1/06 OlE OlE OlE X X X X X
Key:
X=
0=
O/E=
NM=
Present
Absent
AbsentlExcused
No meeting
Not a member
Spouses and relatives of City Council Members and members of comparable
County Boards and Commissions are not eligible for appointment to City Boards
and Commissions. This includes: spouse, child, mother, father, mother- in- law,
father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-
mother, step-child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 2
Council Announcement Date: September 18, 2007
Application Deadline: Wednesday, 5:00 p.m., October 31,2007
Council Appointment Date: November 5,2007
SENIOR CENTER COMMISSION
Two vacancies - Three Year Terms
January 1, 2008 - December 31,2010
Term expires for Betty Kelly, Jay Honohan
Jay Honohan 1RI
151 0 Somerset Ln
(Currently serving 3rd three-yr term)
1RI Denotes applicant completed the Confidential page of the application.
City of Iowa City
Advisory Board/Commission/Committee
Appli,cation Form
1 ~ 1
-~= -~...
!~w~'"!.
~ ~1ID.~.
~<~
CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on
matters of interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington St., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME. ~, I / J, I. c L
<r ~ 0 wa. \ of'1 0 N5#r\ G"""" .,.,
Advisory Board/Commission/Committee Name 5.f #oJ ,~ ~ ~
Term
Youth Advisory Commission, Age on the date offiling:D Age 15 to 17 (or) D A.gEi~18 t021
; i
Signature of parent/guardian if Age 15 to 17:
J A'I \4. \-\ 0 No ha ~
HOME ADDRESS '5"10 S"c)t-\~"$tt I.", ,$ow.... C...~ IA ZIP .5"1.,z'l0
"Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes D No
How long have you been a resident of Iowa City? ,.. , ..., C ~ l 'i tD ()
OCCUPATION I~ t; 0 YON ey EMPLOYER Sf \ ~ ~ f'"\ l~ to J
PHONE NUMBER: HOME~) ~ ,too iQctq (} BUSINESS ~ let) 3 .rl.. f1 (J C)
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EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
,.......
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lAME
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p
-f';>
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€'ih~ "leQ,(~ s~.(vi,,~ (M 1\.e C6"'MI5S"~ "4 c.h.4.',1't..
4c.1-"u.. r&.-lf,c"rA-v+ ~ c:.14sSEH) a...J P(01("~~ s ~:t fJu
C~ .\c.i.
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S' e e. Q. rh~. e ~eJ s k c, e of-
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2006
Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
:c h4"~ S t'V'U ~J (M rA.4 (d Ii M .5S;"'" {(J\f ~\ =, ~.}- ~NlS. .:r
'l~ \AJ<< 1\ ~''\ u. 4CAJ -k,,) (.N' ~ (U '0 H M I j s; 1\3 W,.. Jc.1\""~S. :r
VI '" tJ-t. ~~ c. ~ ~\ w1.... ~ ~\. k. r
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
M~ A. ~ rev i-e ., c.e. O't\ 1\.1.. c. M fo'\ i s r 'M M ,., t.e.s M'f
4 b (e ~ p ("0 vi tJ..f (l j MOO K 't-f 4 tv 5 fit' ~ t'" M 4 Jk S
(.\A..~ +t~ Wt\ QI.{ W A.1 ~+ Yk.4 s.e fJ\"w ~~.
A s 4 ~ ~ (.T\.\x. pCM +\(., ~ P ~ r :t. (tJ,ct/!.\.\J4 I ;:'l?~~~ GM -~
"e.,~ \~ h fA-'; S fro.... 4 ~ p~tl C; flW\ ij ,
S-e.t ~ I-\---c..,,~~ e J s k.u.-t-
._I)
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POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests, including financial interests and your duties to an employer.
, In particular, if you are applying to be a member of a board or commission which makes recommendations tothe
City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 of the Code oflowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is
attached (see page 6).
If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of
theCode of Iowa, please contact the City Attorney's office at 35,6-5030.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? DYes D No
DO YOU CURRENTLY SERVE ON ANOT,!ER IOWA CITY BOARD' OR COMMISSION? D Yes ~ No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
1 ~ J.
_r-= -~
~~ai~'t
~ ~IlIU~
~,~
CITY OF IOWA CITY
Name of City 1:. D fAJ"- '\~ I J." w ) t't\ CCI\Na.-h
Board/Commission/Committee S ~ Nt ' rI C~ .J4v
Name JAy H, \1 0 IV 0 ~'" .r
Date~
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate if there are none.
0",-
BUSINESS NAME
'"t\"Z..2 J S-M.-t.-r
Ou...
BUSINESS ADDRESS
"Z., 'Z.~ J S l-
AHH~
ONO,,""A/
szz~o
,..
J ~h Pol'
i.A..."
,-
NOTE: A new form must be completed if the above information changes or an ow~Ship iFif~restis
acquired in an additional siness. ' ..)
Applicant Signature
Signature of parentlguar n if ge 15 to 17:
Address , S I () S () M ~ 'IS. + J,. /ttJ
rt K o/oJ cJh4~
:CeJ W~ (,-k,
J:'A S2l '4 ()
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2006
Page 3 of 7
EXPLANATION OF EXPERIENCE AND CONTRIBUTIONS
REGARDING MY REQUEST FOR REAPPOINTMENT TO
THE IOWA CITY/JOHNSON COUNTY SENIOR CENTER COMMISSION
I believe that my background and qualifications in addition
to my prior service on the commission make me qualified to serve
on the commission.
Since my appointment to the Commission, I have served as the
chair for eight years and have been re-elected by the other
commission members seven times after my first year as the chair.
I feel that this demonstrates that commission members have
confidence in my service on the commission.
During my service on the Commission, I have been an active
participant at the Center. Currently being enrolled in
intermediate Spanish class and an oil painting class. In 2006,
as a member of the Senior Center Drill team participated in
performances at homecoming, a women's basketball game, and the
Englert theater. I regularly attend concerts, dances, and other
programs at the Center.
I have been for nine years the coordinator of the volunteer
attorney counseling service for seniors conducted each Wednesday
at the Center.
I was active in promoting the donation of funds which
eventually raised $125,000 towards the building of the skywalk
which connects the Center with the adjacent parking ramp. As
chair, I was one of the individuals responsible for informing the
participants of the proposed participant fee program and for
obtaining approval of the program which I believe has proved
successful.
The formation of Iowa City Senior Center Fund, Inc. the
entity which invests donations in the Community Foundation of
Johnson County was my idea. This program has been in my opinion
a real success. Through the foundation, funds have been directed
to the Center to provide updates in a variety of equipment,
including fitness, Senior Center Television, computers, and
furniture.
I believe that I can offer experience and leadership that
will assist the Senior Center to continue to be one of ~he
premier senior centers in the state and to add new and exciting
venues for the Seniors of Iowa City and Johnson County.
>
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NOTICE
THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING COMMISSION:
YOUTH ADVISORY COMMISSION
Two Vacancies - Two-Year Terms
January 1,2008 - December 31,2009
One (1) person - Age 15 to 17 on the date of filing
One (1) person - Age 18 to 21 on the date of filing
The mission of the youth Advisory Commission is to promote understanding and awareness of Iowa
City among Iowa City youth, allow a select group of youth to help make decisions concerning them and
their peers, enable youth members to utilize and expand on their leadership abilities, to serve as a
mechanism for communication between youth and adults in Iowa City and create a bridge whereon youth
and adults can develop partnerships.
All members of the Commission shall be residents of Iowa City and must be the required age on the
date of filing. Said age requirements may be waived by the Council due to a lack of applicants. Meeting
time and location to be determined by the Commission.
Applications must be received by 5:00 p.m., Wednesday, October 31, 2007. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icqov.orq.
Questions about the Iowa City Youth Advisory Commission should be directed to Marian Karr, City
Clerk at 356-5041.
x = Present
o = Absent
OlE = Absent/Excused
NM = No meeting
= Not a Member
KEY:
NAME TERM 1/17 2/21 3/21 4/25 5/30 7/18 7/25 8/22 9/24 10/22
EXP.
Audrey 12/31/07 X X X X X X X 0 X X
Keranen
Sarah 12/31/07 X X OlE X X X X --- --- ---
Ziegenhorn
Un Weeks 12/31/08 X X X OlE X OlE X X X X
David Segar 12/31/08 X X OlE X X X X X X OlE
Maison 12/31/07 X OlE X OlE OlE X 0 X 0 X
Bleam
Jacqueline 12/31/07 X X OlE OlE X OlE OlE --- --- n_
Stubbers
Michael 12/31/08 X X X X OlE X X X X X
Nelson
Hannah 12/31/09 --- --- _n --- n_ --- --- --- X X
Green
(Meeting Date)
YOUTH ADVISORY COMMISSION
ATTENDANCE RECORD
YEAR 2007
DRAFT
Spouses and relatives of City Council Members and members of comparable
County Boards and Commissions are not eligible for appointment to City Boards
and Commissions. This includes: spouse, child, mother, father, mother- in-law,
father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-
mother, step-child, aunt, or uncle. (Resolution 85-354)
Males: 3
Females: 1
Council Announcement Date: September 18, 2007
Application Deadline: Wednesday, 5:00 p.m., October 31,2007
Council Appointment Date: November 5, 2007 (Recommendations to be made by
Council liaison)
*** Said age requirements may be waived by the Council due to a lack of applicants.
YOUTH ADVISORY COMMISSION
Two Vacancies - Two Year Terms
January 1,2008 - December 31,2009
One (1) person - Age 15 to 17 on the date offiling (10:-31-07)
One (1) person - Age 18 to 21 on the date offiling (10-31-07)
Term expires for Audrey Keranen, Maison Bleam
AQe 15 to 17
Michelle Han [R]
1909 Earl Rd
AQe 18 to 21
No Applications as of Wednesday, 5:00p.m., October 31,2007
[R] Denotes applicant completed the Confidential page of the application.
City of Iowa City
Advisory Board/Commission/Committee
;." ~plication Form
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CITY OF IOWA CITY
Individuals serving on Boards/Commissions/Committees play an important role in advising the Council on
matters of interest to our community and its future. Applicants must reside in Iowa City.
After a vacancy has been announced, the Council reviews all applications during the work session. The
appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form
may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the
application to City Clerk, 410 E. Washington S1., Iowa City, Iowa.
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR
THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION
WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY
DURING THAT TIME.
Advisory Board/Commission/Committee Name Youth Advisory Commission
Term 2008-2009
Youth Advisory Commission, Age on the date offiling:[Zj Age 15 to 17 (or) D Age 1~!0 21
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Signature of parent/guardian if Age 15 to 17: <;: -.I
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[\II\.ME Michelle Han
HOME ADDRESS 1909 Earl Rd. Iowa City, IA 52246
Is your home address (listed above) within the corporate limits of Iowa City?
How long have you been a resident of Iowa City? 31/2
EMPLOYER none
BUSINESS 319.541.1348
OCCUPATION Student
PHONE NUMBER: HOME 319.341.3674
EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I am very active in school and in extracurriculars and have set high goals for myself. I am the Volunteer Coordinator
of the West High Student Senate. As Coordinator, I organize numerous volunteer activities to make available to
every one. Some examples include activities with Run for the Schools, Dinners at the Ronald McDonald House and
Pen-pal opportunities with Horn Elementary school students. In addition, I hold leadership positions in
extracurricular activities such as Biology Club where I am Vice-President, STAND (An anti-genocide student
organization> in which I am the secretary and co-founder, and Math Club where, as a four-year member since Junior
High school, I am a executive board member. As a high achieving student, I am very responsible and am able to
handle stress and work. Therefore, I know that I am ready for the responsibility of a Board member.
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2006
Page 1 of 7
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
Although I do not know what the Advisory board specifically has done, I believe its purpose is to have the youth
involved in the community not only passively but also as active members. Through this, I believe that adolescents
"~1ay can become contribute even as adults. The Youth Advisory Board n is a way young adults can start their active
lolvement in the area early on in high school.
WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE
REASON FOR APPLYING)?
I want to join foremost because I want to give a voice to the youth. I think it is important that students, especially high
school students who are starting to become active in the community, a chance to have their say and opinions. As a
high school student, I want to make the contribution as well.
As an active voice in the community I will strive to involve other youth in our area. As a prominent member and
leader in school, sports, and many extracurricular activities, I can positively influence the student body to become
genuinly interested in our own community and become more involved as well.
I am a very motivated individual with strong credentials in both academics and extracurricular activities and I have
been looking for many ways to become involved more on a larger scale with the community, and as the Youth
Advisory Board seems like the perfect match for me, I will give my full time and efforts to the board.
I look forward to being able to participate.
POTENTIAL CONFLICTS OF INTEREST
Please identify any potential conflicts between membership on the advisory board and your personal
interests,including financial interests and your duties to an employer.
, )articular, if you are applying to be a member of a board or commission which makes recommendations tothe
GltY Council about the allocation of City funds, please list any present affiliations you have with agenciesthat
apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other
types of affiliations must be examined on a case by case basis by the City Attorney's office.
You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions,
a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is
attached (see page 6).
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If you are uncertain whether a potential conflict of interest exists or have questions a~ut SeeBon 362.5 of
theCode of Iowa, please contact the City Attorney's office at 356-5030. :?: () ~
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IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [l] Yes ~o ~
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYes [l] No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2006
Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
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CITY OF IOWA CITY
Name of City
Board/Commission/Committee Youth Advisory Commission
Date 10/10/2007
Name Michelle Han
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city
Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see
page 6).
List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have
an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings).
Please indicate if there are none.
BUSINESS NAME BUSINESS ADDRESS
None. None.
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NOTE: A new form must be completed if the above information changes or an ownership interestis
acquired in an additional business.
Applicant Signature /ll?; em II -I/{l17
Signature of parent/guardian if Age 15 to 17:
Address 1909 Earl Rd. Iowa City, IA 52246
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Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
December 2006
Page 3 of 7