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Home My WebLink About16-051l IDENTIFICATION NO. t (Office Use Only) IIIA ``�� ®rte,■ APPLICATION FOR TAXICAB I MOTORIZED PEDICAB VEHICLE DRIVER CITY OF IOWA CITY (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday) 410 East Washington Street Iowa City, Iowa 52240-1826 Failure to complete the "required" information will result in denial of the application (3 19) 356-5040 1319) 356-5497 FAX First Middle ast 1. Name (REQUIRED) /Er1 is 1 S 1= V --)P, E til p 2. Address (REQUIRED) 1pb I M e C 2 U I -Fr-- r- FI ,J Ertl S Z 3 fi 3. Contact Information (REQUIRED) Email: o r•3 t S�� c t J] V('44f+UOCeII Phone, 31nl J�S Q d q 2 3 (All written communication sent via email) 4a. Chauffeur's License expiration date (REQUIR D) b. Taxicab Business Name (REQUIRED) _ k4iil S LJ A X 1 5. Prior experience in transportation of passengers: ,- (F S of rz c o S Iat xf 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? if lif Where When ,JAB iir ATT A e H F- D- o A2 wi,S VIZlEC-OP-d A),Sb What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested/ charged with any traffic offenses in the last five years? i!tyy S Typeof offens I Where When dVA E- ez 20 What happened to thvrhauffeur's cle one) Dismissed Deferred Suspended Plead Guilty Other 8. Has your driver's licelicense been suspended or revoked in the last five years?p Type of offense Where When c;, I 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). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 02/2015 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I herebyy certify that I have issued to me by the Iowa Departmen of Transportation a valid Chauffeur's license number 56 �0 5 O ' O issued on3-1 -1 q xpiring on Q-2 -!B . I understand that if I falsely answer any questions in this application, that this application may be denied. I agree that in making this application, I consent to allow agents or ployees of the City of Iowa City, Iowa, in their discretion, to examine any and all records and documents relating to t- apple tion, and I further a that, if aut orization to be a taxicab driver is granted, to comply at all times with all of the pr isions of itle 5, Chapter 2 of t e City-0di(Needs to be signed in front of a Notary Public) Signature of Applicant / Date 3 ' STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by -T) eukf 4 F— - 7 k -L L 1 H on this 9 day of I have reviewed this application, DCI report, and the State certified driving record of this applicant and have determined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code) Expiration dat of Chauffeur's license f ' 0--Z� ICS �g Signatur of Po ice hief or designee Date AFTER APPROVAL BY THE CITY CLERK YOU ARE AUTHORIZED TO DRIVE A TAXICAB IN IOWA CITY FOR NO MORE THAN ONE YEAR FROM THE DATE LISTED BELOW. Signa of City Clerk or designee Office Use Only c7 3 �� /G Dvate ' Approved application 7- 1 DCI report _ State certified driving record F,7 Website update - ClerkrrAXIDRIVBADGEAPPL92014amended.DOC 0312015 �--�' ov ->>,.,i9t.nn l�w�vw0-cot.g �TER I ��E.`�iPL�F t ��, rJ�;=e !1RIL�t'� io�- _ Office of Driver Services Pik Box 9204 Des Moines. 1.4 5030F_g204 Phar -e: 515-'_44-9f 24 180C -532-s t 21 I Fax. 515-239-1 X537 ww1'i. 10 v: ev' 0i. go -W Inquiry Date: Customer Name: Address: 3/9/2016 3588195 Certified Abstract of Driving Record DL/10 #: 556YY0404(IA) CDL Permit Class: None Class: D Pettit, Dennis Edward Audit #: 601 KIMBERLITE ST Issue Date: City/State: TIFFIN, IA 523409384 Mailing 601 KIMBERLITE ST Address: None Mailing TIFFIN, IA 523409384 City/State: None Date of 9/22/1970 Birth: None Sex: M Convictions 7895115 03/18/2014 Expiration 09/22/2018 Date: Endorsements: 3L Restrictions: NONE Restriction None Supplement: History Information CDL Permit Issue None Date: CDL Permit None Expiration Date: Explanation CDL Permit None Endorsements: 12/08/2015 CDL Permit None Restrictions: IA ID Status: None DL Status: VAL CDL Status: None CDL Permit ELG Status: CDL Cert Status: None CDL Mad Status: None Citation Date Conviction Date ACD Explanation County JUR 11/22/2015 12/08/2015 S93 Speed Johnson IA 0 Name: Pettit, Dennis Edward DL/ID: 556YY0404 Pursuant to Iowa Code §321.10, I, Melissa Spiegel, 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 Direct6r 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: I o: •----•.. V9 3/9/2016 IOWA � ffi 0.0. T.�i�� f)<"'^ Office of Driver Services Iowa Department of Transportation 3/9/2016 Name: Pettit, Dennis Edward DL/ID: 556YY0404 3/9/2016 D STATE OF IOWA Criminal History Record Check Request Form <` To: jewa algwoo 01 Cominst 10"dApHoll Support opera11010 eurmv,10 Floor 115 L 10 Street Per "olaes, lows. 40719 (515) 72"M (515) 915.6080 FOX 4,-frL T t1 �„ DCI AcMiinl Nusnber, Sgt From: t,Njar[.S f aXf Fax IJ td i S - , D I>�Fe—�, on 9 2 z- 7 n QFetnale 17Q l, D 6— QZ G 3 river Ir rormmlon: without a rigoed wntvev rmid the subject oftbe request, a complete ert luRI ►ivory mord mal oat NIMAble, per Code at Iowa, Cbapte� For tliIDl1w CHwloal lderory retard ieformetiwr as allowed by law, Always Waiver waiw ss„s Al of 7�3 _ (�J a soeroh of the ptovldod Dame and date of birds revealed: ❑ No Iowa Criminal History Record found with DCI Iowa C&rjnai History Record attached, DCI # DCI initials ,Received Time Mar. i. 2016 3:08PM No,8637 tie Ulrt,ioe of GlnurS a (pC] use anh) i 0ifi i ILn N Mar. 2. 2016 10:10AM Div of Criminal lnvestigation IOWA CRIMINAL HISTORY DCT 00434455 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 4 DATE PRINTED - 2016/03/02 DCI:00434455 NAME: PETTIT,DENNIS EDWARD PETTIT,DENNZS EUGENE DOB SEX RAC HGT WGT EYE HAIR SKN POB 19700922 M W 600 175 HA2 BRO FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y - SC ABDOM SC CHEST CCH RECORD *+* 01 ARRESTED 19920215 AGENCY: IA0160000 CEDAR CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWT TRK#: L41392601 COURT DISPOSITION AGENCY: IA016015J CEDAR CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 OWI TRK#: L41392601 RESTITUTION SENTENCE DEFERRED JUDGEMENT COURT COSTS SA EVAL PR013ATION lY 02 ARRESTED 19960729 AGENCY; IA0520100 CORALVILLE PD CHARGE NO- O1 IA STATUTE IA708-7(1A2) HARASSMENT IST / DOMESTIC ABUSE HARASSMENT TRK#: 019233801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA708-7(2) HARASSMENT 3RD CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 019233801 SENTENCE FINE $75 03 ARRESTED 19970316 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- O1 TA STATUTE IA321J-2 Owl 2ND TRK#: 025662101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 ONI 2ND DISP EFF DAT 19920508 19920508 19920508 DISP EPP DAT 19961121 No. 8710 F. 1/10 C COURT CASE ID: 06521 OWCRO43919 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 025662101 SENTENCE JAIL 7D FINE $750 PROBATION SY SUSPENDED 53D 8/27/98 -CONTEMPT -10 DAYS JAIL 04 ARRESTBP 20000912 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- D1 IA STATUTE IA236-1 ABLT CAUSING INJURY DOMESTIC ABUBB 2ND TRK#: 100018301 COURT DISPOSITION AGENCY: IAO52015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA708.2A(3)(B) DOMESTIC ABUSE ASSAULT - 2ND OFFENSE - AG CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100018301 SENTENCE JAIL 1801) FINE PROBATION SUSPENDED 05 ARRESTED 20010808 AGENCY: IA0480000 CHARGE NO- 01 DRIVING WHILE BARRED TRK#: 033753001 COURT DISPOSITION AGENCY; IA049DISJ COUNT NO- 01 $500 21 170D 500 OF FINE 9USP IOWA CO SO IA STATUTE IA321-561 IOWA CO DIST COURT IA STATUTE: IA321.561 PAGE 2 OF 4 DISP EFF DAT 19970700 19970708 19970708 19970708 DISP EFF DAT 20010124 20010124 20010124 20010124 DRIVING WHILE BARRED HABITUAL OFFENDER - 1978 COURT CASE ID: 06481 ACCR007517 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 033753001 SENTENCE DISP EFF DAT JAIL 5D 20020301 5 DYS JL/CRD TM 88RVP/F,SC,CC & CT AFP ATTY FEE FINR 20020301 06 ARRESTED 20011027 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321-560 DRIVING WHILE BARRED TRK#: 100300601 COURT DISPOSITION AGENCY; IAO52015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321.561 DRIVING WHILE BARRED HABITUAL OFFENDER - 1978 COURT CASE ID: 06521 FECR000306 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100380601 SENTENCE JAIL 60D FINE $500 PRORATION lY SUSPENDED 45D 07 ARRESTED '20061006 AGENCY: IA052000U JOHNSON CO 90 CHARGE NO- 01 TA STATUTE IA708.2A DOH98TIC ABUSE ASSAULT TRK#' 101998501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA708.2A(2)(A) DOMESTIC ABUSE ASSAULT COURT CASE 10: 06521 SMSM066930 CHARGE CLASST MISDEMEANOR CONVICTION TRK#: 101998501 SENTENCE JAIL 30D COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTES IA664A.7(4) DCI 00434455 PAGE 3 OF 4 DISP EFF DAT 20020221 20020221 20020221 20020221 DISP EPP DAT 20061220 VIOLATION OF NO CONTACT OR PROTECTIVE ORDER COURT CASE ID: 06521 SMSM066910 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101998502 SENTENCE DISP EFF DAT JAIL 7D 20000711 08 ARRESTED 20OB0526 AGENCY:-IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE TRK#: lAO049VOI COURT DISPOSITION AGENCY: , IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA124.401(5) PAGE 4 OF 4 POSSESSION OF A CONTROLLED SUBSTANCE COURT CASE ID: 06521 SRCR0B3530 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: IA0049V0I LICENSE REVOKED SENTENCE DISP EFF DAT SAIL 2D 200BOB20 DL REVOKED 100 DAYS FINE $315 20080820 09 ARRESTED 20080520 A AGENCY: 1A0520500 NORTH LIBERTY PD CHARGE NO- 01 IA STATUTE IA708.7(2) HARASSMENT / IST DEG, - 1989 TRK#: 1A0049W01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA706.7(2) HARASSMENT / LST DEO, ` 1969 COURT CASE ID: 06521 AOCRO92336 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: IA0049W01 SENTENCE DISP EFF DAT FINE $625 20081017 SUSPENDED PRISON 2Y 20081011 PROBATION 2Y 20081017 SUPERVISED PROBATION W/ DCS. PRISON 2Y 20001017 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT. THIS RECORD MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF 7 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