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Home My WebLink About17-022CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa S2240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) 2. Address (REQUIRED IDENTIFICATION NO. (-1— O rZ (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 denial of the application 3. Contact Information (REQUIRED) Email: it%Ae4-z3avRDghAott) .Coy Cell Phone: 31954) �75ZS (All writtencommunication sent via email) 4a. Driver's License expiration date (REQUIRED) 1 16-2-6 2 d b. Taxicab Business Name (REQUIRED) � ( & 5. Prior experience in transportation of passengers: % tl P -S - 1-C - CA -17-3 �N b tet) t Z SymmseS LhfKO'bt=IV1=k- 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense A What happened to the charge? (Circle one) Where 0 Convicted Dismissed Deferred Suspended Plead Guilty Other 7. Have you been arrested / charged with any traffic offenses in the last five years? 4 -Z l -2- o 1 S Type of offense What happened to the charge? (Circle one) Where When Convicted Dismissed Deferred Suspended Plead Guilty Other 8. Has your driver's license or chauffeurs license been suspended or revoked in the last five years? O Type 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 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) 07/2016 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify that 1 have issued to me by the Iowa Deppartment of Transportation a valid Driver's license number ep-79 �A 1� 6 1 issued on Z 14 expiring on j( -Ib za2o 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 employees of the City of Iowa City, Iowa, in their discretion, to examine any and all records and documents relating to this application, and 1 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 M STATE OF IOWA ) COUNTY OF JOHNSON ) sgibed and sworn o before me by �yi r'l�le_fZj°.r— on this day of �11 ',:ELL:1E:K:F�RUElNGHL 819 N�mNot6ry Public in and f the State of Iowa MY co OWE 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). or designee I(/ �6� ZO I- D to 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. Si lure City Clerk or designee Office Use Only Approved application DCI report State certified driving record Website update -7:qcI,II1 Date ClerkrFMIDRIVBADGE PL92014amended.DOC 07/2016 C410WADOT 'SMARTER I SIMPLER I CUSTOMER DRIVEN www.lowado goy Inquiry Date: 2/2/2017 Customer #: 1984143 Name: Metzler, David Milton Address: 310 N GEORGE ST City/State: NORTH LIBERTY, IA Convictions Office of Driver Services PO Boz =41 Des Moines, to I50306i9204 Phone., 515-244-9124 1.80D-532-1121 1 Fax: 515-239-1837 www.icwadot.gov Certified Abstract of Driving Record DL/ID #: 523179671 Mailing 310 N GEORGE ST Address: D Mailing NORTH LIBERTY, IA City/State: 523179671 Date of Birth: 11/16/1958 Sex: M Convictions Office of Driver Services PO Boz =41 Des Moines, to I50306i9204 Phone., 515-244-9124 1.80D-532-1121 1 Fax: 515-239-1837 www.icwadot.gov Certified Abstract of Driving Record DL/ID #: 075AA1861 (IA) CDL Permit Class: None Class: D CDL Permit Issue None IS92 ISpeed Date: IA Audit #: 8637174 CDL Permit None Johnson IA Expiration Date: Issue Date: 11/21/2014 CDL Permit None Endorsements: Expiration Date: 11/16/2020 CDL Permit None Restrictions: Endorsements: 3 ID Status: None Restrictions: Corrective Lenses DL Status: VAL Restriction None CDL Status: None Supplement: CDL Permit Status: ELG CDL Cert Status: None CDL Med Status: None History Information Citation Date Conviction Date ACD Explanation County JUR 05/29/2012 06/20/2012 IS92 ISpeed Johnson IA 03/31/2013 04/29/2013 N63 Driving Wrong Way on One Way Street Johnson IA Name: Metzler, David Milton DL/ID: 07SAA1861 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 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: >.:••••••.;P�hy 2/2/2017 IOWA D. 0. T.; � f' r '/%"••••"•S Office of Driver Services Iowa Department of Transportation Name: Metzler, David Milton DL/ID: 07SAA1861 State of Iowa Division of Criminal Investigation 215 E. 7th Street Des Moines, Iowa 50319 Phone: 515/725-6066 Fax: 515/725-6080 Iowa Criminal History Record Check Walk -In Request Your name: 1 )4 Q tj wle'r2L (: Address: 0 24 C! T Cit /State/Zi d R y) 61Z 31 Phone #: 3Z i Z4 Reauestinu, an Iowa criminal history record check on: Fill in all shaded areas. Last Name Ape//l,h, [m.mdatory) First Name Primer Nombre (mandatory) Middle Name Segundo Nombre (recommended) `:)::)i4V 1 M l LTafJ "S_TZ_L919, Date of Birth Fecha Nacimienlo (mandatory) Mender Genera (mandatory) Social Security Number (recommended) I I _ I &-s-g KNlale [:]Female-83-�=�-8 Waiver Sign atu re Firma (If the request is on urseIC please sign. If the request is on someone else, write N/A.) DCI USE ONLY Results As ofr:Z) , a name and date of birth check revealed: ❑ No record found Record attached DCI # 313 y J DCI initials CCG_ -. Receipt T Number of requests x $15.00 per last name = Total amount $ Method of payment: x cash money order check # MasterCard or Visa (last 4 digits) Cardholder's name DCI initials QIL ----------------------- ------------------------------------------------------------------------------------------------------------------ Credit Card # Exp. Date DCI -83 (09/09/10; Revised 10/1/10; form reviewed 08/11/14) IOWA CRIMINAL HISTORY DCI 00312314 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED - 2017/02/01 DCI:00312314 NAME: METZLER,DAVE METZLER,DAVID MILTON DOB SEX RAC HGT WGT EYE HAIR SKN POB 19581116 M W 600 150 HAZ SDY MED IA ADDITIONAL IDENTIFIERS DISP EFF DAT 19831126 19831126 19831126 19831126 DISP EFF DAT 19890628 19890628 CCH RECORD *** O1 ARRESTED/TAKEN INTO CUSTODY 19831126 AGENCY: IA0570000 LINN CO SO CHARGE NO- 01 IA STATUTE IA321-281 OPER WHILE INTOX TRK#: L25116101 COURT DISPOSITION AGENCY: IA057015J LINN CO DIST COURT COUNT NO- 01 IA STATUTE: IA321-281 OMVUI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L25116101 SENTENCE FINE $300 PROBATION 6HRS CRED-PROS TIL 020885 SUSPENDED 2D CREDIT W/TIME SERVED 02 ARRESTED/TAKEN INTO CUSTODY 19890405 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J-2 OWI 2ND TRK#: L25116201 COURT DISPOSITION AGENCY: IA0520ISJ JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 OWI 2ND CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L25116201 SENTENCE JAIL IOD CREDIT 7 HRS/PAY SURCHG FINE $750 03 ARRESTED/TAKEN INTO CUSTODY 19940807 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA321J-2 OWI 2ND TRK#: 006445901 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 DISP EFF DAT 19831126 19831126 19831126 19831126 DISP EFF DAT 19890628 19890628 OWI 2ND CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 006445901 SENTENCE JAIL 15D FINE $750 PROBATION lY SUSPENDED 35D PAY SURCHG 04 ARRESTED/TAKEN INTO CUSTODY 19981125 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA709-4 SEXUAL ABUSE 3RD DEGREE TRK#: 032253001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA 709-11 ASSLT W/INTENT COMMITT SEX ABUSE NO INJURY CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 032253001 RESTITUTION SENTENCE PLEAD GUILTY FINE $500 PROBATION 2Y SUSPENDED 2Y DCI 00312314 PAGE 2 OF 2 DISP EFF DAT 19940928 19940928 19940928 19940928 DISP EFF DAT 19990526 19990526 19990526 19990526 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 DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION V