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Home My WebLink About13-285 Authorization Number / - A -> � r 1 (Office Use Only) I As=NOtlir CITY OF IOWA CITY APPLICATION FOR TAXI DRIVER (Police Department review must be made 410 East Washington Street between 8 a.m. to 3 p.m., Monday—Friday.) Iowa City. Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX First Middle L s 1. Name ( L v- S�- -� yr 1 -� S n 1 2. Mailing Address /6 .</ I her„r 11,,szA t-teiN vV 3. Telephone: Home ( �l 3 Other: 4. Prior experience in transportation of passengers: I r p O t& y 1/C'& C 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? /`C 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? K._ Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? N.P. Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? 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). (OVER FOR REQUIRED SIGNATURE AND NOTARY) Jeri axidrivbadg 03/2013 I b . certify tiyat IAhavsuer4,o e by the Iowa Department of Transportation a valid Chauffeur's license number Cil � f- Pt_ �j . 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^ ,, r a e:"--b � k Date /- `— ' _`\ ****************************.******************************************************************************************************************** STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by (h r 1 S P SkO 1 �- On this 02-74-1'\- day of 11 -e VAk_ i �--E%.I 'e- l — � (( / , KELLIE K. U-RLE l L c 1� LL t—t �{ i "` Notary Public in and for the State of Iowa -, 'o Number 221819 Co ' 1-- -' ce ************************************************************************************************************************************************ 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). ,!� , is-ate /� Signatur of Poli.' ief or designee/ /O Date 6 r 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. jj 2` lk-' f 1 1. J 7-/3 Signa re of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width)and 51/2" (height)and prominently displayed to all passengers. ********************,...********************************************************************************************************************** Office Use Only Approved application DCI report State certified driving record Website update derMaxidrivbadgeapp2010.doc 0312013 v Iowa Department of Transportatio �f ce of Driver Services (Tcl Free)81 532 1121 15-244-9124 "-Pg O Box 9204iir , Des rvloines; IA 50306 9204 F,,�(• 516-239-1837 Certified Abstract of Driving Record Inquiry Date: 11/13/2013 Customer#: 3450361 Name: DL/ID #: 980AA2189 (IA) None VAL Skola, Christopher Lee Class: C ID Status: Address: 1041E BURLINGTON ST APT Audit#: 2896200 Non 1 DL Status: City/State: Issue Date: 01/06/2009 CDL Status: None IOWA CITY, IA 522403229 Expiration Date: 12/03/2013 CDL Cert Status: None Mailing Address: Endorsements: NONE CDL Med Status: None 1041 E BURLINGTON ST APT Restrictions: Corrective Lenses Restriction 1 None Mailing City/State: Date of Birth: 12/3/1968 Supplement: IOWA CITY, IA 522403229 Sex: M History Information Accidents -Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accf yE•:, 05/04/2012 Case Number 687533 7UR Name:Skola, Christopher Lee DL/IDIA ; 980AA2189 Pursuant to low the custodianIowa Code §321.10, I said office, anof the records Kim Snook that I held by the Office Director of Office of have been authorized byof Driver Driver Services, Iowa De the Directory of t S, that this is a true accuratetatiopy oi`Transportation, do In witness of the ioand co p hereby certify that I am s whereof, I have caused mywa Py of an official record currently in the custody of signature and Department of Transportation to so cert; the seal of the Department to be set upon this document, at Ankeny, Iowa this date. / -- ••., -d'Pt#, 11/13/2013 :.DOWA e 0. T. . �; r ,K,„,,,,,,, el 11 r,��F�RIVEft..4.-.7f �� Offi Driver ce of S Name: Iowa Department Christopher of Trans Pher Lee DL/ID; 980AA2189 Portation Authorization Number // 1 (Office Use Only) • item 11:4111 r APPLICATION FOR TAXI DRIVER CITY OF IOWA CITY (Police Department review must be made 410 East Washington Street between 8 a.m.to 3 p.m., Monday—Friday.) Iowa City, Iowa 52240-1826 (319) 356-5040 (319) 356-5497 FAX First Middle Last 1. Name ( Liv- • S` r-� DL r— L---2— S� 1 c 2. Mailing Address /b T l I - ( v.� i vt tiC 1 3. Telephone: Home ( 9 3 3 / Other: 4. Prior experience in transportation of passengers: brave_ C cNO--�f)cz l/ Vek 1 c le 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? 1-C 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? fJT Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? NI' Type of offense Where When 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? ks-73 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). (OVER FOR REQUIRED SIGNATURE AND NOTARY) clerkftaxidrivbadg 03/2013 I b_er9b4 certify tf�t IAhav�sue . ole by the Iowa Department of Transportation a valid Chauffeur's license number A- . 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 a_J cylck, Date /(--/ -6.--T----( ''S STATE OF IOWA ) COUNTY OF JOHNSON ) 1 cubed and sworn ./o before me by �!hriS +o 'CI-Pf- , �- On this � !`�- day of e V Ak_ic.W ri ,4C: I 1J -e.L( �� k (• U. 1 Le rami KELLIE K.TUTTLE s"' 'o Numialber 221819 Notary Public in and for the State of Iowa My co -ly':L 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). /41 .1,, /a -ate /7 Signatur of Poli.' ief 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. 4 < ..4mo71 /. / ) 7-Z3 Signa ure of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 1/2" (width) and 5'/2" (height) and prominently displayed to all passengers. ***********************************************************************.************************************************************************ Office Use Only Approved application DCI report State certified driving record Website update GerWtaxidrivbadgeapp201 D.doc 03/2013 Iowa Department of Transportation c:81 If Office of Driver Services (Toll Free)800-532-1121 PO Box 9204, Des Moines, IA 50306-9204515-244-9124 FAX: 515-239-1837 Certified Abstract of Driving Record Inquiry Date: 11/13/2013 DL/ID #: 980AA2189 (IA) Customer#: 3450361 Name: Skala, Christopher Lee Class: C ID Status: None Address: 1041 E BURLINGTON ST APT Audit#: 2896200 DL Status: VAL 1 Issue Date: 01/06/2009 CDL Status: None City/State: IOWA CITY, IA 522403229 Expiration Date: 12/03/2013 CDL Cert Status: None Endorsements: NONE CDL Med Status: None Mailing Address: 1041 E BURLINGTON ST APT Restrictions: Corrective Lenses Restriction None 1 Date of Birth: 12/3/1968 Supplement: Mailing City/State: IOWA CITY, IA 522403229 Sex: M History Information Accidents-Accident involvement indicated does NOT mean the individual was at fault or given a citation. 05/04/2012 687533 IA Name: Skola, Christopher Lee DL/ID: 980AA2189 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: 0-`vEi 7:4GI., 11/13/2013 4: IOWA�'-wi VII D. O. T.141,1 44:17- C3416-cosck '..%„vd i i% Office of Driver Services Iowa Department of Transportation Name: Skola, Christopher Lee DL/ID: 980AA2189 • 7 Dec. 16. 2013 12: 15PM Div of Criminal Investigation No. 8301 P. 2/7 • vec. It al) ):J4rn 'dm/ �lerrc - �lty of Iowa t,ity . Iuo. ef F. 2 p. • STATE OF IOWA °v atJl'!,t uoe ,t„ l or� rte el Criminal History Record Cheek �„ intim,�l.Il Request Form • ca't(LrrS•• DCI AccountNumber: (irepplioeble) To: Xowa flvtslmt of Criminul Inveitigatlon stroma CITY OF IOWA CITY Support Operations Bureau,l'I Floor CITY CLERIC'S OFFICE x15)t, 1'h Street 410 E WASHINGTON STREET Dos Moines,Iowa 60319 (515)725-6066 _TOWq_C 91,A 522,40 (515)725.6050 Fax Phone: 319-3565041 non 319-356-5497 . I ern requesting an Iowa Criminal History Record Cheek ono Last Name(mandatory) First Name(mandatory) _ Middle Name(rcwmmeaded) Date of Birth(mnndsloyj Candor(mandatary) O Social Security NUS er(reeommomicd) —� — cc S 110 QFenmala Waiver information:Without a signed waiver from the subject at the request,n complete criminal hlstoryrecord taay not be releasable,per Code oflawa,Chapter 6922,For complete,criminal history record information,as allowed by law,always' obtain a waiver signature from the sub feet of therequnst. • Waver Release:Thereby givepermission for the abovc reyursnngoaiclnl to conduct on Iowacriminal history mord checkwllh Iho I:vision otcriminal Inns ligation(OC1). Any criminalhis:ow data con mming me slut Ismaintained by the Mims)! ailed m• owed by lam, raw Waiver Signature: _ I_. J (� a i ki 4 Iowa.Criminal Llistory Record Check Results Q Unto only) As of `'7.I `DI tip , a search of the provided name and date of birth revealed: Et No Iowa Criminal History Record found with DCT ter Iowa Criminal Histoty Record attached,DCI# 14O,5351° DCI initials Vlb Received Time Dec, 12. 2013 3:33PM No. 8098 Dec. 16. 2013 12: 16PM Div of Criminal Investigation No. 8301 P. 3/7 IOWA CRIMINAL HISTORY DCI 00405602 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 2 DATE PRINTED- 2013/12/16 DCI:00405802 NAME: SKOLA,CHRIS SKOLA,CHRISTOPHER SKOLA.CHRISTOPRER LEE DOB SEX RAC HOT WGt EYE HAIR SKN FOB 19681203 M W 508 135 HAZ BRO MED IA ADDITIONAL IDENTIFIERS TAT CHEST TAT R SHLD CCH RECORD *** 01 ARRESTED 19900526 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA204-401 P085 SCH I-MARIJ TRH#: L38044401 COURT DISPOSITION AGENCY; IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA204-204-4 POSE SCE I MARIJ CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: L36044401 SENTENCE DISP EFF DAT FINE $150 19910327 PAID SURCHG 02 ARRESTED 19930507 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA714-2-2 THEFT-2ND TRK#: 009617101 CHARGE NO- 02 IA STATUTE IA321J-2 OWI TRK#: 009617102 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA714-7 OPERATING W/O OWNER'S CONSENT TRK#: 009617101 SENTENCE DISP EFF DAT DEFERRED JUDGEMENT 19931104 COURT DISPOSITION AGENCY: IA052015J JOHNSON CD DIST COURT COUNT NO- 02 OWI CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 009617102 SENTENCE DISP EFF DAT Dec. 16. 2013 12: 16PM Div of Criminal Investigation No. 8301 P. 4/7 DCI 00405802 PAGE 2 OP 2 JAIL 2D 19931104 FINE $500 19931104 03 ARRESTED 19990802 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA124-401 POSH SCH I W/INTENT DELIVER/AID AND ABET TRK#: 046832701 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE IA124-401(5) FOSS CONTR SUBS SCH I-MARIJ CHARGE CLASS: MISDEMEANOR CONVICTION TRIO: 046832701 SENTENCE DISP EFF DAT JAIL 5D 20000128 FINE $250 20000128 COURT COSTS 20000128 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 INVESTIGATIONNnr_} 1