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Home My WebLink About16-070OT4 �tolf._ CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1 826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) 2. Address (REQUIRED, IDENTIFICATION NO. I �e — (0-7C) (Office Use Only) APPLICATION FOR TAXICAB / 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 deniai of the application 3. Contact Information(REQUIRED) Email: QriGnk.- k-j6-7E1nn ( 0 ro Cell Phone: 3-Voc (P6, (All written comn1inication sent via email) " 4a. Chauffeur's License expiration date (REQUIRED) b. Taxicab Business Name (REQUIRED) -1 5. Prior experience in transportation of passengers: _ 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense 1 Where What happened to the charge? (circle one) Convicted Dismissed Deferred Suspended ad Guiltyl Have you been arrested I charged with any traffic offenses in the last five years? Where 55 . When /s Other When /- - 1q/*o What happened to th ce ha ge (Circle one) + ' { �iU I (p T Convicted Dismissed Deferred Suspended Plead Guilty Other /1 ' 8. Has your driver's license or chauffeur's license been suspended or revoked in the e years? ,ry 0 Type of offense Where When i 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please provide, the (tame(s).. T 0 Td DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE'CERTIFED DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIEF RMEW c.n 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 hereby cert tha have issued to me by the Iowa De artment of Transportation a valid Chauffeur's license number .rT /j3 �/ issued on ,��C�-.?cleexpiring on �_,��-�d/�/. 1 understand that if I falsely answer any questions in this application, that this application may be denied. Iagree that 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 authorization to be a taxicab driver 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 _3 -30 -,Ta STATE OF IOWA ) COUNTY OF JOHNSON ) SLjbscribed and sworn to before me by ,p`,gv\ on this 3 C7 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 date of Ch fF ur's license _ ignature of Police Chie esignee z31�q 6 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. Signatarb of City Clerk or designee Office Use Only Approved application DCI report State certified driving record Website update 3lye Dat cie,Wr JDRIVMDGFAPPr92014ame�deaooc 0312015 1!] ca cie,Wr JDRIVMDGFAPPr92014ame�deaooc 0312015 10WA DOT StAARIER I SIMPI ER I CUSTOMER DRIVEN vWVW.iawadoG goV office of Driver Sei P4 Box 9204 t Elea Moines, fA 50306-9204 Phone: 5i5-244-9124 1 8 dFax: 515-239-1937 WWW-iowadotgov Certified Abstract of Driving Record Inquiry Date: 3/23/2016 DL/ID #: Customer #: 1131912 Class: Name: Meyer, Brian Joseph Audit V; Address: 16 METRIC RD issue Date: 06/2C/2D14 CDL Permit Expiration Date: City/State: IOWA CITY, IA 522403002 Endorsements: Mailing Address: 16 METRIC RD Restrictions: L ID Status; Restriction Mailing IOWA CITY, IA 522403002 Supplement; City/State: CDL Status: VAL Date of Birth: 5/23/1959 ELG Sex: M Convictions 059AA1934 (IA) CDL Permit Class: None 8 CDL Permit Issue Date: None 8183806 CDL Permit Expiration None Office of Driver Servlces Date: Iowa Department of Transportation 06/2C/2D14 CDL Permit None Endorsements; 05/23/2019 CDL Permit Restrictions: None L ID Status; None NONE OL Status: VAL None CDL Status: VAL CDL Permit Status: ELG History Information CDL Cert Status: Excepted Intrastate CDL Med Status: None Citation Data Conviction Date ACD Explanation County JUR 01/26/201fi 102/09/2016 . - - ;M34- Following Too Close . 'Johnson IIA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. nrcident Data Case Number 31/26/2016 __._ _. _.. _.- JUR 903]80' IA Name: Meyer, Brian Joseph DL/ID: 059AA3934 Pursuant to Iowa Code 4321.10, 1, 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 officlal 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, 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, 3/23/2016 IOWA :a'% D. 0. T.:� lyw�opae;? �Y / O ORIYEH $`fit Office of Driver Servlces Iowa Department of Transportation Name: Meyer, Brian Joseph DL/ID: 059AA1934 25. 2016 2:28PM D l v c Criminal Investigation No0449 P, 1/3 F•-•. --:-> .0-- —." G6.- .... ,' 03/24/2016 12,os yaaq P.002/002 STATE OF IOWA 0, j Criminal History Record Check Request Form' TO: Iowa Divlsiun of Criminal Investigation Support nneratinns Bureau, 1" Flour 115 F. 711' Street Des Moines, Iowa 50.319 (515) 725-6066 (515)'725.6080 Fax M eyt:-r s -a2 -s7 6r: IJCI Account Nuluber: _LL0 "t_. — (rappl¢ablt) From: Cii of Iowa CI[ - City CEerIPs OfAcc 410 C. washln tion 6tr'Cet Iowa Cit— y-- Z, 11A 52240_.. Phone: 319-356-5041 _ Fax: 319-3566497 ®]dale ❑Female J-05 e- P '1178 6) 6 Iya1Ver tnefortuatlon,' wifhout a signed waiver from the subiact of the request, a complete criminal history record mey not be releasable, per Code of Iowa, Chapter 692.2. For cornMete criminal history record information, as allorved re lard, Always ayno obtain a waiver sl nature f mo the subject of the reauesr_ Waiver ReleaSe:1 hembygivc pcnnission for tilt aheyt rcquesting Dfficial to conduce an loe'a criminal history record chcek Ai Ilk the Division of Criminal Invesli&alion (M), Any criminal history data eonce�rjning me that is mail) lalncd by the DCI maybe released as Allowed bylaw, WaiverSiprarrtrrre: 'd�'Lc.-... ��tV.r � l_Owa Criminal history Record Check Results m> �. cry ((J,CI V•Se only) As of 5 iD a search of the provided value and date of birth revealed: c. -,:l: C; ; 'n ❑ No Iowa Criminal History Record found with DCI 1 o r: forvd Criminal Histor}/Record attached, DCI #�lp� 1XIinitials t� D(:I-77 (08/25/10) — -- Received Time Mar. 24. 2016 11:52AM No.0539 Mir.25. 2016 2;28PM Div of Crimloa1 1nvestiEatioo IOWA CRIMINAL HISTORY DCI 00264890 PAGE 1 OF 2 DATE PRINTED- DCI:00264890 2016/03/25 NAME: MEYER,BRIAN JOSEPH DOE SEX RAC HGT WGT EYE HAIR SKN POB 19590523 M W 600 160 BLU BRO LOT IA ADDITIONAL IDENTIFIERS CCH RECORD w** 01 ARRESTED 19800418 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321-281 OMVUI TRK#: L17978501 COURT DISPOSITION AGENCY: IA05201SJ JOHNSON CO DIST COURT COUNT NO- Cl IA STATUTE: IA321-281 OHVUI TRK#; L17978501 SENTENCE DISP EFF DAT JAIL 2D 19600625 FINE $500 19800625 02 ARRESTED 19810124 AGENCY: lAOS202CO IOWA CITY PD CHARGE NO- 01 IA STATUTE TA321-A32 DRIVE UNDER SUSP TRK#+ L17976601 COURT DISPOSITION AGENCY: IA05201517 JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321�A32 DRIVE UNDER SUSP TRK#: 1,17978601 SENTENCE DISP EFF DAT PLEAD GUILTY 19810227 PINE $150 19810227 03 ARRESTED 19871107 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA204-401 FOSS BCH I MARIJ TRK#: L17978701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA204-401 POSE SCH I MARIJ TRK#: L17978701 SENTENCE DISP EFF DAT FINE $150 19871124 No- 0449 F. 2/3 Mar, 25. 2016 2:28FM Div of CrlmfnaI Iouestlgatioe DCI 00264$90 PAGE 2 OF 2 No. 0449 F. 9/9 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 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 OZNY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION