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Home My WebLink About12-277CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 356- 40 1IlAq � (319) 356-5497 FAX Authorization Number. /,�� — a -77 (Office Use Only) APPLICATION FOR TAXI DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday.) First Middle Last 1. Name S oil Robert 6` CL 2. Mailing Address S9 0 sle 2J .kt $2 Iowa C,�A SZ Z`1 S 3. Telephone: Home 219 - 54 ( - OS ( _� Other: 4. Prior experience in transportation of passengers:ST 6v�y" [oh L- u# r'«_ ( 5. I-INve you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? _ Type of offense Where When 6. Have you been convicted of operating a motor vehicle while under the influence of alcohol or drugs in the last five years?_ N voe of Offense Where When G MfVUI O�V�ho�• iA Cj tI ollab H(�Q ((nr1. c, . AIC1�. j GS 4-P— c`Y LJOC.r 7. Have you been convicted of any traffic offenses in the last five years? Type of offense Where When C peed Sotiu2a C�� ilc Z001 T11 S,rePO.wy Soy"A' Cv-h-,L 1 ?0 10 8. Has your dri4r's license or chauffeur's license been suspended or rbvoked in the last five years? 00, 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) 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) darM.idmbadg 09/2012 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number, 13 °1 ,A C 1 t3) 3 . 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 1 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 =::Z 1 __ Date **F##**#*H##****R**#*R**RFRRRf4RHf411f4f#N1f1HH1f4H141#HRHfifHlf4H*4f *f4fH41HHRRRFIIR*i*f 11HRlfff RIRRRRRR**1RFR*RFRRFRR1R111HHff STATE OF IOWA COUNTY OF JOHNSON bs nbed and sworn to before me by JG04 6 ✓ G�� On this 3Y� day of K. TUTTL �)of ry 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). Signgt i e of Pgji hief or designee Date 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. Signatute of City Clerk or designee Taxi cab businesses are required to provide Driver Identification cards. Office Use Only Approved application DCI report State certified driving record Website update /'')_- f -ice Date deM.idnM.dg.X2010 m 09/2012 �! Des. 3. 2012 11:49AM VNov.20. 2012 12:57PM Div of Criminal Investigation City Clerk — City of Iowa City (iJ,Hminatlf3Gistou Record Check Requegtt JFor>rea To: IotVA l)blsror, of Crfmidal7avastldatfoh Supp ort Oparations Euronu,l'I bToov 215 �, 7�h Street bo,cb�o(nos,To`tva 60�Y9 (519)729.6066 (5T5) 72S-6000 Nast Without a ho ro1eps96[B, por Code ohtaih d Watvars(enatu YYraWrAWamre.Ihoft a(vo pe:Nlss(0a TnYaslfdanan (POb- Any orlminal Newrydala W No.6436 P. 1 No.3026 P. 2 ACYAocouat TWborr (lfapp11w0 0) Wain% T7 i 05 ZOGLd CITY cxxx e>;rx;,z's eaaxc� 41n A R&SIYf6TGTOh7 6TJIMT xowa cM IM 522&ft- pl,onA; , �I4��5R-50rx1 Maxi X19 g56-54.47 Name 12 CIO, it-- 1 edit, ►- 1 AA wgyavftom i&im Jeotofthe requeaPo a rompfoto afmrna[ htsfory rorord mayno6 r69a2,krorco'arfmfnafhtofoayrocordlnfoxmetfoa,asalCovvedEyCavi�,alrrays ORIV1611u LOnduafm YOWa criminal hhlolyeeeorddeck wi7h McDWar( OM1rnfno1 I AM by Ihonolmoy 6o rolcasod ns nl(mYed 6y law XOWA Cxi��libY3Z Ifioiar 1�ee xc �k1eeosttif.;�� : (Aoitl "n J As of lex6l ]— a search 0f the pro Med name aiid, dato QMb thx6vealed: ' Ej Nbxbwa6--ImInal-WistoxyRecordNjudwith DCl === KV &pyaCriminaIiilstoxy Record at(aohed,1)CZ# 199 ��viuva Time •AI,... 9h W1 11-Upm Nn 4919 X012 11:49AM Div of Criminal Investigation IOWA CRIMINAL HISTORX pCi 00261899 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED - 2012/12/03 DCI:00261899 NAME: GRAU,SCOTT ROBERT DOB SEX RAC HGT WGT EYE HAIR Sm POE 19551124 M W 601 168 BLU SRO MED IA ADDITIONAL IDENTIFIERS SC BACK CCH RECORD •*+ 01 ARRESTED 19800129 AGENCY: IA0770300 DES MOINES PD CHARGE NO- 01 IA STATUTE IA321-281 OMVUI TRK#: L17524201 COURT DISPOSITION AGENCYT IA077015J POLK CO DIST COURT COUNT NO- 01 IA STATUTE IA321-281 OMVUI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L17524201 DRUNK DRIVING SCHOOL SENTENCE DISP EFF DAT PLEAD GUILTY 19800418 PROBATION lY 19800418 DEFERRED SENTENCE lY 19800418 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 ENF RCEMENT AGENCIES BY THE DCI. IN ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS B 0 FORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD CO S _ SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION No, 6436 P. 2 CIowa Department of Office of Driver Services PO Box 9204, Des Moines, IA 50300-9204 Inquiry Date: 11/20/2012 Name: Grau, Scott Robert Address: 590 Foster Rd #b2 City/State: Iowa City, IA 52245 Mailing Address: 590 Foster Rd B2 Mailing City/State: Iowa City, IA 52245 Convictions Transportation (Toll Free) 800-532-1121 515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record DL/ID #: 139AC1873 (IA) Class: D Audit #: 2759031 Issue Date: 11/18/2008 Expiration Date: 11/24/2013 Endorsements: 3 Restrictions: Corrective Lenses Date of Birth: 11/24/1955 Sex: M History Information Customer #: 3383405 ID Status: None DL Status: VAL CDL Status: None CDL Cert Status: None CDL Med Status: None Restriction None Supplement: Speed Citation Date Conviction Date ACD Explanation County IUR o4/61/2009 05/05/2009 S92 Speed 52 IA _ 01/30/2010 04/09/2010 S92 Speed 52 IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number IUR 08/07/2008 454523 IA 09/14/2012 703032 IA Name: Grau, Scott Robert DL/ID: 139AC1873 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: ti."..... /,ji'41 11/20/2012 IOWA D. 0. T. Jar pF Office of Driver Services UdlVWt%S�r y...... Iowa Department of Transportation Name: Grau, Scott Robert DL/ID: 139AC1873