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Home My WebLink About18-033� r CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 (3 19) 356-5040 (319) 356-5497 FAX 1. Name (REQUIRED) IDENTIFICATION NO. /P�> —p33 (Office Use Only) 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 Middle Last 2. Address (REQUIRED) \?-O G ilaw Si -"`i �>, 0 BOY, C� b 1:� �<&&Q ),At- S 2 OLA 3 3. Contact Information (REQUIRED) Email: A Vatx DVs�k wood,PdJ Cell Phone: 10 54 (All written coirnmunication sent via email) 4a. Driver's License expiration date (REQUIRED) I I -2 q - 20 6 b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of pa C-`-ctt I.Lt\,. cavS, 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where VCO-, When What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other Have you been arrested / charged with any traffic offenses in the last five years? * t Type of offense Where When Jo�w 5pn i2 -a& -?o13 V ned to the charge? (Circle one) da It nvic d 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? u 0 Type of offense Where When 9. Have you ever applied to be an Iowa City taxi driver using a different name? If yes, please prDgidg themame(e� I X --N O D_t ;PU DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE4RTIF ED t DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHI ROEW 0 c� o You must apply for an individual Department of Criminal Investigation Report (form avail6le upon request). rV �O (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 07/2016 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 I hereby certify that I have issued to me by the Iowa Department of Transportation a valid Driver's license number t 3q ,qG issued on % S -la 11 expiring on It 2 v - 2a I B . I understand that if I falsely answer any questions in this application, that this application may 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 authorization to be a taxicab driver 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_ Date MRlt**4#141RM!#RRM1RlMlifR4*#M11MRR#}R**#R!########*#i}}#M#Y44f##M#M4M4MYMYll11H1f4!lMlRMlflMflf 4ffl1M1RllM1R!*f4Hl4i*#4*#*#} STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by `JL+e'tt; i C fZ%_L-_ on this day of 'LCtZ— < 1 1 in and for the 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 date of rive ' license rr- Z 03 ature of Police Chief or designee 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. Sign6ture of City Clerl r designee Date _,,,,,,M„**•**'**}=MM,.**•#*i4Y#*!MlM,4Y#,!lf,RlYM,f!lf,fMM,=R,,,#*_}'*}**'_*_*'**•#*##}***#••***##*_*_*__*_**___***___'•#___*=*==#414 Office Use Only N b Approved application o, DCI report State certified driving record D --i ;;u Website update n-< 71 ra o `- c-) m a c � o Cl.kTAXIDRIVMDCaEA 0201 Cemmtle0.D00 07/2016 r4) Iowa Department of Transportation OfiDe of Dmw SwvwAn (Call Ffee) W&632 1121 FO Ow 9204, Des mores, IA 503069204 515244-5124 FAX 515 239-1837 History Information Convictions Citation Date Certified Abstract of Driving Record ACD Inquiry Date: 2/27/2018 DL/ID #: 139ACIS73 (IA) Customer #: 3383405 Name: Gmu, Scott Robert Class: D ID Status: None Address: 120 S MAIN ST APT Audit #: 1935799 DL Status: VAL Fail to Obey Traffic 4 IA Si n SI nal Issue Date: 07/05/2017 CDL Status: None City/State: ELKADER, IA 52043 Expiration Date: 11/24/2018 CDL Cert Status: None Si n SI nal Endorsements: Chauffeur 3 CDL Med Status: None Mailing Address: PO BOX 96 Restrictions: Corrective Lenses Restriction None Improper Lane Linn 11A Supplement: than in lanes Date of Birth: 11/24/1955 Mailing ELKADER, IA Sex: M City/State: 520430096 History Information Convictions Citation Date Conviction Date ACD Explanation County IUR 12/06/2013 01/08/2014 M14 Fail to Obey Traffic Johnson IA Sign/Signal 06/07/2014 11/19/2014 M14 Fail to Obey Traffic Johnson IA Si n SI nal 02/07/2015 06/10/2015 M14 Fall to Obey Traffic Johnson IA Si n SI nal OS 23 2017 06 OS 2017 Defective LI hts Linn A 05/23/2017 06/05/2017 M42 Improper Lane Linn 11A than in lanes Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. N O Cn Name: Glu, Scott Robert DL/ID: 139AC1873 y r Pursuant to Iowa Code §321.10, I, Melissa Spiegel, Director of Office of Driver Services, Iowa Departrife' p Transporta ,, do -cc a hereby certify that I am the custodian of the records held by the Office of Driver Services, that this is a lw%d agurate ®of an official record currently in the custody of said Office, and that I have been authorized by the Directo g� Iowa Department J� 4-D 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: 2/27/2018 IOWA D. 0. T.' y� Office of Driver Services Iowa Department of Transporation Name: Grau, Scott Robert DL/ID: 139AC1873 N O S y, a m � o �> N vD Mar. 2. 2018 2:49PM Div of 03/Oz/LUla ai:aaAm rnA 3103nueovc 02Ma.r:_ 2, 2018.E 9:38 NO Div of ✓;fie. Criminal Investigation Criminal Investigation No. 5094 (rwlg33B.No. 4431 STATE OF XOW;A Crimival Histoky Record Check Recluest-Poi�m P ��02/0002 211002 K'a ver Ir(/ormattort; Without a signed waiver from tho sublect o1 the rogpaaq a complete at•iminal history record ,a,.y na. bo roioaaablo, psr Code o(1ew°, Chapter 692.2, For co erlmloal hirtor •rotor Information oANin a Wa1Ver el netu a from Ike suh tet of the ro uos�� " y P ' all°wed by 1°N', a1W°yr, WaivaiRe[ease: [hereby On permtutoo for No store regh01dnk4mdld10 dondOtl M Iowa odnAaol Amory MWd thele with the Dtvl 1nvCJJ el(eh (DCC} Any aknN°I hWoy din mnumina me a InWMd V the 001may Da le i as allo%v0 lylew, rlon of (klminil Waiver Signature: (DCl Us enlyl M of a soarOh of the provided name and date of birth revealod; ❑ No Iowa Criminal history Rcoord found with DCI Iowa Criminal history P006rd attached, DCI M aC�, \bel c);• o i':: -.6r— .1M DClinitlale, �(i '- D(;r_77 109/21/161 Co RR t c e i Y'e if Time'tMar, 2. 020 182 11 ; 39AMo.No. 5045 AC1AocountNumber; 9967-F • ' - 1'01 Iowa piYlslen of Grimina,lnvesrlgauon t(rWpnubli) .Support operatlont,Baroeu, I" [+toor Promt lie low Cab of Iowa City_ 219 E. P Strati r P,d. Bax 428 Dm Mx0319 (513) 725.602$.a66d - 1'0 A (A PAY : OR ' IOWA City$ L 52244 (SIS) 1,2"080 FIX 1"111, RJ- ;1111':"I` AG% ,IiV, I"LP " F2' "I' �N '1"FII' Ji�hdl�8;1 (3X9) 338-9777 az: 0319) 9-7302 IOWA 11rtllns)YVVt 'Record Check on; dvo Irst Name ineu H11 roto 1 LUOStln a; yyl��e K'a ver Ir(/ormattort; Without a signed waiver from tho sublect o1 the rogpaaq a complete at•iminal history record ,a,.y na. bo roioaaablo, psr Code o(1ew°, Chapter 692.2, For co erlmloal hirtor •rotor Information oANin a Wa1Ver el netu a from Ike suh tet of the ro uos�� " y P ' all°wed by 1°N', a1W°yr, WaivaiRe[ease: [hereby On permtutoo for No store regh01dnk4mdld10 dondOtl M Iowa odnAaol Amory MWd thele with the Dtvl 1nvCJJ el(eh (DCC} Any aknN°I hWoy din mnumina me a InWMd V the 001may Da le i as allo%v0 lylew, rlon of (klminil Waiver Signature: (DCl Us enlyl M of a soarOh of the provided name and date of birth revealod; ❑ No Iowa Criminal history Rcoord found with DCI Iowa Criminal history P006rd attached, DCI M aC�, \bel c);• o i':: -.6r— .1M DClinitlale, �(i '- D(;r_77 109/21/161 Co RR t c e i Y'e if Time'tMar, 2. 020 182 11 ; 39AMo.No. 5045 Mar. 2. 2018 2:50PM Div of Criminal Investigation IOWA CRIMINAL HISTORY DCI 00261899 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF 1 DATE PRINTED- DCI:00261899 2018/03/02 NAME: GRAU,SCOTT ROBERT DOB SEK RAC HGT WGT EYE HAIR SKN POB 19551124 M W 601 168 BLU SRO MED IA ADDITIONAL IDENTIFIERS SC BACK CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 19800129 AGENCY: IA0770300 DES MOINES PD CHARGE NO- 01 IA STATUTE IA321-281 ONVUI TRK#: L17524201 COURT DISPOSITION AGENCY: 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 19000418 PROBATION IY 19800418 DEFERRED SENTENCE IY 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 ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIPICATIO14 THIS RECORD IS BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. y^�� DIVISION OF CRIMINAL INVESTIGATION No.5094 P. 2 N O_ � m (? c N o �r-rn m = T' N tD