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Home My WebLink About13-166 Authorization Number I 1(-0(e I 1 (Office Use Only) 'se WI OE 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 iiy oiaa 52240-1826 jII9) 356-50'iri 9AI (319) 356-5497 FAX First Middle Last 1. Name _ 4 )) Sfe_veA se N 2. Mailing Address !1-S . 5 t( IA S1 5 4- 'k/',---ci TA 3 t 3'S 3. Telephone: Home 31q-331-D3 Other: 4. Prior experience in transportation of passengers: I In--✓c. Q/;ve n f^Xi r A S,ncq_ d,00I 5. Have you ever been convicted of any misdemeanors and/or felonies in this State or elsewhere? tcs 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? A/0 Type of Offense Where When 7. Have you been convicted of any traffic offenses in the last five years? ��c Type of offense Where When AiltiS(—F:x (a 31(7b009 8. Has your driver's license or chauffeur's license been suspended or revoked in the last five years? A/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) 4/0 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AN TE CERTIFIED QRIVINGEGORQ MUST ACCOMPANY THIS APPLICATION FOR POLICE C You must apply for an individual Department of Criminal Investigation Report(form available upon request). (OVER FOR REQUIRED SIGNATURE AND NOTARY) derk/taxidrivbadg 03/2013 w I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Chauffeur's license number 0 �iifx Y S'4 t'l-' . 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) / r Signature of Applicant Date -6701\ STATE OF IOWA ) COUNTY OF JOHNSON ) 1 S escribed an sw rn t before me by ( I l I e ( S--e e Vt n . On this /,2‘.141--- day of r4`k YE'LIE TUTT' Notary Public in and for the State of Iowa ° Commission Number 221819 •z My Co i i n pires ****************************** Y�l**},,,*..- ii* **a cas********************************************************************************* 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). .141 c7 Sign re of Po / 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. e / e - 4e4,1_,% - /, /, � Signature of City Clerk or designee Date Taxi cab businesses are required to provide Driver Identification cards. Cards must be 8 '/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 derkltaxidrwbadgeapp201 0 doc 03/2013 • IOWA USA DRIVER LICENSE -r'STEVENSON DANIEL BARRATT Q 115N5TH ST WEST BRANCH,IA 52358 - o0.55015 sss 07116/201012010 EXP 01 Sex OiassD Eon 3L r Hot 5 10" A RestrictionsEyes BRO „ ppNORY DOB 0712001977 00 y 07/20/109M200715R Page 1 of 1 Iowa Department of Transportation C3 Office of Drnrer Sennces (Toll Free)800-532-1121 pp Box 9204, Des Manes. IA 50306 921 4 515-244-9124 IIIIIP FAX:515-239-1837 Certified Abstract of Driving Record Inquiry Date: 8/7/2013 DL/ID #: 555XX5497 (IA) Customer#: 1217962 Name: Stevenson, Daniel Class: D ID Status: None Barratt Address: 115 N 5TH ST Audit#: 4518598 DL Status: VAL Issue Date: 07/16/2010 CDL Status: None City/State: WEST BRANCH, IA Expiration 07/20/2015 CDL Cert None 523589615 Date: Status: Endorsements: 3L CDL Med None Status: Mailing Address: 115 N 5TH ST Restrictions: Corrective Lenses Restriction None Date of Birth: 7/20/1977 Supplement: Mailing City/State: WEST BRANCH, IA Sex: M 523589615 History Information Convictions Citation Date Conviction Date ACO Explanation County JUR 03/17/2009 04/16/2009 592 Speed (10 mph &under in 35-55 mph zone) Muscatine IA Name: Stevenson, Daniel Barratt DL/ID: 555XX5497 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: ^®. ,.....,,.,(�i� 8/7/2013 4-.: ,r4„ ''. 4 • frzejogeps„ iraervoicyrA • I. Il.,i �i' � r Office of Driver Services ��``\. �r: Iowa Department of Transportation Name: Stevenson, Daniel Barratt DL/ID: 555XX5497 8/7/2013 • CSh -'e1V1iVU§i Ol £lOZ 'S 'nnV awiI pan'iaaae . 1 IQ Wokyang ptova bolCilipuaa VAT ' ii pneeeenipAs °ail1ppar;etauupv'p1Ao4e41ictwiWas>a'� 1\\a1 if) 3o pry. 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