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HomeMy WebLinkAbout12-120I r 1 = i �r"III �,;���__4MM CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX First 1. Name slv 2. Mailing Address =�2 O 4;? ifW74' S Authorization Number APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) Middle 3. Telephone: Home 3 1 CI - 2 c% r - 7 Other: 4. Prior experience in transportation of passengers: / (2 t r - Last ice` --�) COe(4)a IV /2- -/�_)c (Office Use Only) 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere'? Q S Type of offense Where When 6. Have you bgen convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years? ry o Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? W 0 Type of offense Where When 8. Has your drivers license or chauffeur's license been suspended or revoked in the last five years? 0 Type of offense Where When 9. Have you ever applied to bq an Iowa City taxi driver using a different name? If yes, please provide the name(s) 0 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) The re- port will be mailed to the individual making the request and needs to be reviewed by the Police Chief with this appli- cation. (OVER FOR REQUIRED SIGNATURE AND NOTARY) c1eWWidrivbedg 09/2010 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number I understand that if I falsely answer any questions in this application, that this application may bet i? . I understand that if I falsely answer any of the questions in this application, that this application will be denied. I agree that n 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 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 Stz , S STATE OF IOWA COUNTY OF JOHNSON Date Syb cribed and sworn to before me by etic S- f I/e Ll On this o) 7 day of 26 1Z KELLIE K. TUTTLE ��_C !�- $ Commission Number 22Iel otary Public in and for the State of Iowa ow "� 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). --�27, Date 6--2-7-12- Date -.z7-/2- Date After Police Chief and City Clerk have approved authorized taxi driver names will be placed on the city website at icgov.org. Taxi cab businesses are required to provide Driver Identification cards. 4#*441.*4*4444**,44**441444.#441444R141ff.#HMR#4441#441RR44444f44R444444444444444*4*%#4+F#Yt#####*##R1R#RR.##R11411#RRR4441RR.R*f144.14R«.1f14RR Office Use Only Approved application DCI report State certified driving record Website update ded idri edgeapp2010, c 09/2010 �r Jun, 4. 201"2) 2:19FN Div of Criminal Inv estigationy . .. No -7548 P. 1/2 r r L'1 JT r . L STATE OP IOWA C4w1paMstory Record Chock ♦' ry 4 xo: Yo:v9bryrsWnofCr[m[npl.Xnvosi7gst[on Support operatlons Suroqu, •1'I,p[oor a15,E 7'"StreoL Ilea M91199, Iowa 9MI9 (,sis) yzs.bab6 (513) 925-6080 Vat Cheok , ) G ACX AccognEN'pm6er: `' W �•"�Y OpapyticaT~ )From, crry or roma. G= OM cLM119 02XGA 470 I/._ WASMW—G= STREET � �cowA c2xs roL7� X240 3'[tOnA; R79-95fi--R(1la.T - �AS(t 319-95�s6n7 _� �q'�DOP7i)1iE11(manAalaWl i'Ii6h/TAN! .n,inlnwY.Qnn90717emYS•rHiN��N.7.a..i_..__. .... waiver W[[hout A signed VveiVa111oM lhesu6leAB of tUa xeggev(; a reMplatA m[tq[np[ hlsfdry recazlJ Iupy)1pE 6aroleaspb[e,porWeofrnw,Chvter•orTmfnAIL1storyrdCora lnlbkmntlon,avalloyedVIM, AIWRys • oDEafndwatversf na[utvtYomfBe•nub dctoftildke bsE2 ll�l'G7 �Ga✓eRSe:Ihcrc6ygfvepWahsfonfor (vconduc[enro%,acdmtn(AIgoyeuuloheckWilhlhcgtislnnorcrmrnof rnros[NWOA [OCA, rmy011Alla&fNsmrydem�dnwmingniolnnUenutnitlna[llylKob01mgy6orofcesadavAIIOWddby[A% WalverSl�rtrrdurel .... � 'ts-���¢,�/ �. •, r ,. Auora xiu4� ux�s rox� tae�ora a. necK Jt�t srxit� .. 'roCl t�nanlY> As of L�� /� a seuaCli tSfthD pYo vided named datD DEhi>thieYeared • 1V'o Tuwa Glirr�inpi ]H;4atory kecord found with r) Ci : , rowa QW11al ]itstozy Pword fasohod, x)(21 r, loci Initials Received time$ ay, 25. 2012 2:53PM No. 70 Jun. 4. 2012 2:20PM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCT 00340221 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- DCI:00340221 2012/06/04 NAME: STRIBLEY,STEVE LOUIS DOB SEX RAC HGT -WGT EYE HAIR SKN POB 19520515 M W 507 155 HA2 BRO MED IA ADDITIONAL IDENTIFIERS CCH RECORD *** 01 ARRESTED 19851128 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA123-46 PUBLIC INTOX TRK#: L29294001 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA123.46 CONSUMP'T'ION / INTOXICATION CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L29294001 SENTENCE DISP EFF DAT PLEAD GUILTY 19851120 FINE $20 19851128 COURT COSTS $20 19851128 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 DC1. 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 0 No.7548 P. 2/2 '44M*3Iowa Department of Transportation Office of Driver Services {Toll Free) WU-532-11129 Pt? Box 9294, Des Moines, 1A 543UE-92D4 595-244-9124 FPJC:595-239-9837 Certified Abstract of Driving Record Inquiry Date: 5/25/2012 DL/ID #: 769YY3916(IA) Name: Strlbley, Stephen Louis Class: D Address: 2028 9TH ST APT 2 Audit #: 5217755 Restriction None Issue Date: 05/11/2011 City/state: CORALVILLE, IA 522411525 Expiration Date: 05/15/2016 Endorsements: 3 Mailing Address: 2028 9TH ST APT 2 Restrictions: Corrective Lenses Date of Birth: 5/15/1952 Mailing City/State: CORALVILLE, IA 522411525 Sex: M History Information CLEAR DRIVING RECORD Name: Stribley, Stephen Louis DL/ID: 769YY3916 Customer #: 699878 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Pursuant to Iowa Code §321.10, I, Kim Snook, 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: Vit"^au7/j 4� 5/25/2012 IOWA , *''s 4 ). CVIv 0. T..-.- ' r L••�a::•S` Office of Driver Services —' Iowa Department of Transportation Name: Stribley, Stephen Louis DL/ID: 769YY3916