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Home My WebLink About18-032A01 CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319) 3S6-5040 (319) 356-5497 FAX 1. Name (REQUIRED) _ 2. Address (REQUIRED) IDENTIFICATION NO. I $ ` 04 (Office Use My_)`-, APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday - Friday) Failure to complete the "required" information will result in denial of the application rJ.>i S 7W A2 C1 3. Contact Information (REQUIRED) Email:: ") 01 5 �lE Tt"r f i0 (� (All written communication sent via 4a. Driver's License expiration date (REQUIRED) / -2z - / o b. Taxicab Business Name (REQUIRED) G L_ L-0 w 3 5. Prior experience in transportation of passengers: _/,_K; o n� k106' ell Phone: 3 email) A2C6 S o S�z 3 6. Have you ever been arrested / charged with any misdemeanors and/or felonies in this State or elsewhere? vt s of offense Where When o m What happened to the charge? (Circle one) �n cn r Convicted Dismissed Deferred Suspended Plead Guilty -9ftr -0 M Have you been arrested / charged with any traffic offenses in the last five years? bl� S o N Type of offense Where When F 5N-rl� (Do ij1"'Dj a , 2015 What happened to the chap alge? (Circle one) S�!'�n`v'c;� Dismissed Deferred Suspended Plead Guilty Other 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). (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 07/2016 ,r APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify that I h ve issued to me by the Iowa Diepartme t of Transporttion a valid Driver's license number S S (n � Y o �{ 8 issued on 3 -!$ — / expiring on - 2 Z - / . I understand that if I falsely anrswer any questions in this application, that this application may be denied. I agree that in making this application, I consent to allow agents or ployees of the City of Iowa City, Iowa, in their discretion, to examine any and all records and documents relating to 1 ' application, and I furth gree that, if authorization to be a taxicab driver is granted, to comply at all times with all of the pr isions of Title 5, Chapter , of t e ity de. eeds to be signed in front of a Notary Public) i Signature of Applicant~ Date STATE OF IOWA ) COUNTY OF JOHNSON ) -),e u u�, a �. j� i t on this ! S day of .IA e. L -7^ 1905 I have reviewed this application, DCI report, and the State certified driving record of this applicant and have determined that there is no information which would indicate that the issuance would be detrimental to the safety, health or welfare of resi- dents of the City of Iowa City (Title 5, Chapter 2, City Code). Expiration da of e ' se 77 Sign of Police Chief or designee oR-ZZ -Tr/ef o3 -it -/P Date AFTER APPROVAL BY THE CITY CLERK YOU ARE AUTHORIZED TO DRIVE A TAXICAB IN IOWA CITY FOR NO MORE THAN ONE YEAR FROM THE DATE LISTED BELOW. Signa re of City Clerl r designee Date Cl&kfTMDRMLODGEAPPL92014am ded.DOC 07/2016 Subscribed and sworn to before me by N 0 a -n Office Use Only —+ : fir- -v Approved application m a DCI report o� N State certified driving record y Website update r Cl&kfTMDRMLODGEAPPL92014am ded.DOC 07/2016 Subscribed and sworn to before me by CIowa Department of Transportation Office d Carrel Swvkes (roll Floe) 800532.1121 PO Box 9204, Des Mattes, tA 50306-9204 515244-9124 FAX 515239-1837 Convictions Citation Date I Conviction Date Certified Abstract of Driving Record I Explanation Inquiry Date: 3/15/2018 DL/ID #: 556YY0404 (IA) Customer #: 3588195 Name: Pettit, Dennis Class: D ID Status: None Edward Address: 601 KIMBERLITE ST Audit #: 7895115 DL Status: VAL Issue Date: 03/18/2014 CDL Status: None City/State: TIFFIN, IA Expiration Date: 09/22/2018 CDL Cert Status: None 523409384 Endorsements: Chauffeur 3, CDL Med Status: None Motorcycle Mailing Address: 601 KIMBERLITE ST Restrictions: NONE Restriction None Supplement: Date of Birth: 09/22/1970 Mailing TIFFIN, IA Sex: M City/State: 523409384 History Information Convictions Citation Date I Conviction Date ACD I Explanation Count JUR 11122/2015 12/08/2015 S93 Seed Johnson IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date Case Number JUR 10/18/2017 1009474 IA Name: Pettit, Dennis Edward DL/ID: 556YY0404 Pursuant to Iowa Code §321.10, I, Melissa Spiegel, 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: IOWA D. 0. T Name: Pettit, Dennis Edward DL/ID: 556YY0404 3/15/2018 Office of Driver Services Iowa Department of Transporation r aMarr.14."20184:�1:56PNCob Div of Criminal I vestigation No. 5969 P. 1/5 TNg318338uue r,uu21002 STATE OV IOWA " Crimituad History Record Cheek. ` • Request Form � ACI Account Number; 99674 • (Ifappllcablo) To: IOWA DIv(slon of Criminal Invostlgation From: Yellow Cab oflowa Ci ly Support Operations Bureau, l" Floor P.O. Box 428 215 E. 7 Street Dea) 725 6066 wa 40319 Town City, IA. 52244 (515)775-6066 ' (515) 725.6080„ Fax (319) 338-9777 Phone: Fay: (3X9 39-7302 I am revuestine an Iowa Criminal Hicenrvlt P,,.m rJ,.tr Last Name imandaro First Name (mandatory).. Middle Name reaommendad -9D OA P—) ' Date of Blyth (mindnory) Gender (mandato'So Fial $xprl Number recommmda 79 Malo ❑Remnle �$ - 0 ZG'3 Waiver InfOrnratlon; Without a signed waiver from the subject of the rogpest, a complete criminal history record may no be releasable, per COdd of Iowa, Chapter 692.2. For complete criminal historyreeord information, ox allowed by law, always obtaln a waiver Signature froin the suh'tict of the re uact. WaiverRelease:Ihereby glvapermtsslo orlhaabovetcq tin5oaalAto UanIowa ermin blatoryreeerdehedcwiththeDivhlonaP4lndnal InrosUaatlan (DCI) Any cr m nal al:m y de neeml's me Uta! malmined by t may be rt)eaapd �l allowed bylaw. Waiver As of J//W I S , a search of the provided name and data of birth revealed: 11 No Iowa Criminal History Record found with DCT Iowa Criminal History Record attached, DCI 9 S DCl initials �C Received Time Mai4~9.'e201E11b:16AM No -5352 (DCI we only) • Mar.14. 2018 1:59PM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00434455 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 4 DATE PRINTED - 2018/03/14 DCI:00434455 NAME: PETTIT,DENNIS EDWARD PETTIT,DENNIS EUGENE DOB SEX RAC NGT WGT EYE HAIR SKN POB 19700922 M W 600 175 HAZ BRO FAR IA ADDITIONAL IDENTIFIERS PHOTO AVAILABLE: Y SC ABDOM SC CHEST DISP EFF DAT 19920508 19920508 19920508 DISP EFF DAT 19961121 No.5969 P. 2/5 CCN RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19920215 AGENCY: TA0160000 CEDAR CO SO CHARGE NO- 01 TA STATUTE IA321J-2 OWI TRKN: L41392601 COURT DISPOSITION AGENCY: IA016015J CEDAR CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J-2 OWI TRKN: L41392601 RESTITUTION SENTRNCE DEFERRED JUDGEMENT COURT COSTS SA EVAL PROBATION lY 02 ARRESTED/TAKEN INTO CUSTODY 19960729 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA708-7(lA2) HARASSMENT 19T / DOMESTIC ABUSE HARASSMENT TRK#: 019233801 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA700-7(2) HARASSMENT 3RD CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 019233801 SENTENCE FINE $75 03 ARRESTED/TAKEN INTO CUSTODY 19970316 AGENCY: IA0520100 CORALVILLE PD CHARGE NO- 01 IA STATUTE IA321J-2 ONI 2ND TRK#: 025662101 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: TA121J-2 OWI 2ND DISP EFF DAT 19920508 19920508 19920508 DISP EFF DAT 19961121 No.5969 P. 2/5 Mar.14. 2018 1:59PM Div of Criminal Investigation PCI 00434455 PAGE 2 OF 4 COURT CASE ID: 06521 OWCRO43979 CHARGE CLASS: MISDEMEANOR CONVICTION TRKN. 025662101 SENTENCE DISP EFF DAT JAIL 7D 19970708 FINE $750 19970708 PROBATION lY 19970708 SUSPENDED 53D 19970708 8/27/98—CONTEMPT-10 DAYS JAIL 04 ARRESTED/TAKEN INTO CUSTODY 20000912 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO— 01 IA STATUTE IA236-1 ABLT CAUSING INJURY DOMESTIC ABUSE 2ND TRK#s 100018301 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE: IA706.2A(3)(B) DOMESTIC ABUSE ASSAULT — 2ND OFFENSE — AO CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 100018301 SENTENCE DISP EFF AAT JAIL 180D 20010114 FINE $500 20010124 PROBATION 2Y 20010124 SUSPENDED 170D 20010124 500 OF FINE SUSP 05 ARRESTED/TAKEN INTO CUSTODY 20010808 AGENCY: IA0490000 IOWA CO SO CHARGE NO— 01 IA STATUTE IA321-561 DRIVINO WHILE BARRED TRK#: 033753001 COURT DISPOSITION AGENCY: IA048015J IOWA CO DIST COURT COUNT NO— 01 IA STATUTE: IA321,561 DRIVING WHILE BARRED HABITUAL OFFENDER - 1978 COURT CASE ID: 06401 AGCR007517 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 033753001 SENTENCE DISP EFF DAT JAIL 5D 20020301 5 DYS JL/CRD TM SERVD/F,SC,CC & CT APP ATTY FEE FINE 20020301 No. 5969 P. 3/5 Mar.14. 2018 1:59PM Div of Criminal Investigation 06 ARRESTED/TAKEN INTO CUSTODY 20011027 AGENCY: IA0520000 JOHNSON CO 50 CHARGE NO— 01 IA STATUTE XA321-560 DRIVING WHILE BARRED TRK#e 100380601 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO— 01 IA STATUTE: IA321.561 DRIVING WHILE BARRED HABITUAL OFFENDER - 1978 COURT CASE ID: 06521 FECR060306 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#+ 100380601 SENTENCE JAIL 60D FINE $500 PROBATION lY SUSPENDED 45D 07 ARRESTED/TAKEN INTO CUSTODY 20061006 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO— 01 IA STATUTE IA708.2A DOMESTIC ABUSE ASSAULT TRK#. 101998501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA708.2A(2)(A) DOMESTIC ABUSE ASSAULT COURT CASE ID: 06521 SMSM066930 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101998501 SENTENCE JAIL 30D COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE: IA664A.7(4) DCI 00434455 PAGE 3 OF 4 DISP EFF DAT 20020221 20020221 20020221 20020221 DISP EPP DAT 20061220 VIOLATION OF NO CONTACT OR PROTECTIVE ORDER COURT CASE SD: 06521 SMSM066930 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 101998502 SENTENCE DISP EFF DAT JAIL 70 20060711 08 ARRESTED/TAKEN INTO CUSTODY 20080528 AGENCY: IA0520200 IOWA CITY PD CHARGE NO— 01 IA STATUTE IA124.401(5) POSSESSION OF A CONTROLLED SUBSTANCE TRX#: IA0049VOl COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IAI24.401(5) No.5969 P. 4/5 Mar.14. 2018 1:59PM Div of Criminal Investigation DCI 00434455 PAGE 4 OF 4 POSSESSION OF A CONTROLLED SUBSTANCE COURT CASE ID: 06521 SRCROB3530 CHARGE CLASS: MISDEMEANOR CONVICTION TRX#: lAO049VOl LICENSE REVOKED SENTENCE DISP EFF DAT JAIL 21) 20080820 DL REVOKED 180 DAYS FINE $315 20080820 09 ARRESTED/TAKEN INTO CUSTODY 20060528 A AGENCY: IA0520500 NORTH LIBERTY PD CHARGE NO- 01 IA STATUTE TA708.7(2) HARASSMENT / 1ST DEG. - 1989 TRK#: 1A0049WO1 COURT DISPOSITION AGENCY: IAOS2015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA708.7(2) HARASSMENT / 19T DEG. - 1989 COURT CASE ID: 06521 AGCROB2336 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1A0049WO1 SENTENCE DISP EFF DAT FINE $625 20081017 SUSPENDED PRISON 2Y 20081017 PROBATION 2Y 20081017 SUPERVISED PROBATION W/ DCS. PRISON 2Y 20081017 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 INVESTZGATION No. 5969 P. 5/5