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Home My WebLink About12-270-4 `++ Al CITY OF IOWA CITY 410 East Washington Street Iowa city. Iowa 52240-1826 ' (319) 356-5040 CAL, f -Kt On� (319) 356-5497 FAX 1. Name 2. Mailing Authorization Number APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) .Jov, t b fi✓l /A - � 70 (Office Use Only) 3. Telephone: Home 3/ 5> 5--Z_'65 ( Other: t 4. Prior experience in transportation of passengers: iJode- 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? AM Type of offense Where When 6. Have you be convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?_ TVpe of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? C's 7 - Type of offense Where When ;,J A5H11_0N1) Co'wtu o fd a req✓ 20 r l 8. Has your drivel's license or chauffeur's license been suspended or revoked in the last five years? a 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) NP 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) derl widrlvbe g 09/2012 b yz A H 7 9,2 3 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number i I I A I ! 2"� . I understand that if I falsely answer any questions in this application, that this • application May be denied. I understand that if I falsely answer any of the questions in this application, that this application will 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 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 Applicant U" T Date ! / l�Nl l ,, �I Vr"""Yt<�� /ZO/Zc7�L #R%#RfR%RRfRRRf*Y#####+%+RRRRRR4RfflfiRlft*fY*fY#*%%FR*RR%RRR*Rifffih*ifYH###+###*iii#+#+##%+*F#RR*%RR*%R*%M#f*f#**#Y4####F#F+%R R+R*RRRRf*RRhf STATE OF IOWA ) COUNTY OF JOHNSON ) ubscribed a sworn to before me C I e b CJ's s� o� rrt VJAt r .2- G 12, y h -,-NOn this day of _ Notary Public in and for the State of Iowa My 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). gnat a of Police Chief or designee YOU ARE NOT VALID TO DRIVE A TAXI IN IOWA CITY UNTIL AUTHORIZATION IS RECEIVED FROM THE CITY CLERK'S OFFICE. Authorized taxi driver names are placed on the city website at icgov.org. �� _k • ka4 % %/- a.0 - / ;L- Signatu a of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Office Use Only Approved application DCI report State certified driving record Website update de,M cidrivbadgeapp=0.d 09/2012 S: Iowa Department of Transportation Office of Driver Services (Td! Free) ODD -532-1121 4" PO 9mt 9294, Des Moines, IA 5=15-92(k1 515-244-9124 FAX: 515-239-1837 Inquiry Date: 10/30/2012 Name: Fenton, Christopher Harold Address: 429 SOUTHGATE AVE City/state: IOWA CITY, IA 522404401 Mailing Address: 429 SOUTHGATE AVE Mailing City/State: IOWA CITY, IA 522404401 Certified Abstract of Driving Record DL/ID #: 642AH7923 (IA) Class: D Audit #: 6427923 Issue Date: 10/30/2012 Expiration Date: 06/10/2017 Endorsements: 3L Restrictions: Corrective Lenses Date of Birth: 6/10/1963 Sex: M History Information CLEAR DRMNG RECORD Name: Fenton, Christopher Harold DL/ID: 642AH7923 Customer #: 6032481 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restrictlon None Supplement: Pursuant to Iowa Code §321.10, I, Kim Snook, Director of Office )f 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: "•` 10/30/2012 IOWA •{R ).O.T r'• •••'• Office of Driver Services i-� Iowa Department of Transportation Name: Fenton, Christopher Harold DL/ID: 642AH7923 5} G Ir e 5 e (lei'' Nov. 19. 2012 4: 01 PN r Div of Criminal Investigation iNo, 4603 IP. L1/1 y taaltev (briminaMstory ry, t) 6110 I l� I I�1tilaTo d5exnaZe I 2``�`-( " qLf— (9 9 c1 j iVef .&for7naYi,ON, Wfthout a glgned Vt'glVor 1Yom IhasubJeot of tfia Yeg4aA a 60,PloEb odrdnp l hisfory record cony not >1eaSabre�perCodwynryp,ChaptcrOMMIbrco Iet ..acrlmfnalhistoryYecoYdtaYormatlohln9alloWadbyldVr,khvays r_ ....... . . Wil�er.$e%pya; IaerceygWa pe�misrleat�rdranooveraquesana omvFel to condvotattrown odmtnal IdaeoryceeprdchrfJcwlni il�ep�;9loa oCcimr�af Ynvarflgnllon(DCI)•AgycrlmltalLisforydnWoonpo�nfn Mo1hRt7.y}naMrof yiheD�fjowfoasedassfID%Vcdbylaw. )Yr IverSi'grm alnet e� Iowa C.Ambal JEUatot< • Recara (check Results , MP we ons) As of �-71 asaarohofthaprovidednameandd000fbitth fVra1Od: ' iv 1V'oIo+,vxCriminal FlisBoryRecord found with DCY YOW4 Orhwinal Ridgy Re Cud MOW, D CI# N y. DCi: ataitiels� y7 ,Y�97 f0Al2$/1111 Received Time Nov. 9. 2012- 1:15PM No. 6679 X)CIAcoonnMbmber; '1oOa—F • (feePpircenk) To; xo%Vnbt41110herwroinal-yuw4freArtoh Nromr QTTY ox TORA QI7Y 5uppoYt0�e�afi6nsRuloAu>i'f 21SFi.7 Sfreei lopl _ CITY CI;M19 ORMCE Dpa Niglges� TolVa 50379 410 7z uAsOiRMzi 8TRHw ' (gls) 7Z9.6o66 CITY 7okYA 52240 (515) i2�b09Q y+nrc _ -ToVA ' Phonal x319-956—"y�11 •�, IYAxI gta_aSt•;�5G.47 X �_ I ani re aestln an Iowa CriminaiHt or Record Chaolc on; C roena,��e �Y3('�plf],8 mpndAfB �ti()TO.�AIYIo recommended ' 7:-r oa/ t) 6110 I l� I I�1tilaTo d5exnaZe I 2``�`-( " qLf— (9 9 c1 j iVef .&for7naYi,ON, Wfthout a glgned Vt'glVor 1Yom IhasubJeot of tfia Yeg4aA a 60,PloEb odrdnp l hisfory record cony not >1eaSabre�perCodwynryp,ChaptcrOMMIbrco Iet ..acrlmfnalhistoryYecoYdtaYormatlohln9alloWadbyldVr,khvays r_ ....... . . Wil�er.$e%pya; IaerceygWa pe�misrleat�rdranooveraquesana omvFel to condvotattrown odmtnal IdaeoryceeprdchrfJcwlni il�ep�;9loa oCcimr�af Ynvarflgnllon(DCI)•AgycrlmltalLisforydnWoonpo�nfn Mo1hRt7.y}naMrof yiheD�fjowfoasedassfID%Vcdbylaw. )Yr IverSi'grm alnet e� Iowa C.Ambal JEUatot< • Recara (check Results , MP we ons) As of �-71 asaarohofthaprovidednameandd000fbitth fVra1Od: ' iv 1V'oIo+,vxCriminal FlisBoryRecord found with DCY YOW4 Orhwinal Ridgy Re Cud MOW, D CI# N y. DCi: ataitiels� y7 ,Y�97 f0Al2$/1111 Received Time Nov. 9. 2012- 1:15PM No. 6679