The URL can be used to link to this page

Home My WebLink About18-099CITY OF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (319)3S6-5040 (3 19) 356-5497 FAX Last 1. Name (REQUIRED) 2. Address (REQUIRED 3. Contact Information (I IDENTIFICATION NO. /9�>—r)qq (Office Use Only) APPLICATION FOR �"W ;MOTORIZED PEDICAB VEHICLE DRIVER (Police Department review must be made between 8 a.m. to 3 p.m., Monday— Friday) e:,ta ccp 9g A1111'.0 tt�� CI I( CLEV;1%,.. ioj, itA CITY, �O'_+ First Middle 4a. Drivers License expiration date (REQI b. Taxicab Business Name (REQUIRED) 5. Prior experience in transportation of passengers: 6. Have you ever been arrested/ charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense What Where 7. Have you been arrested / charged with any traffic offenses in the last five years? When Type of offense Where When MT) mSLLP1"N.CA IOtQc� Gt-tt q 12'-1 I11 l�lD ln5t�nr ncc IDtyC. 31 1Z Fo- lLxQ-e,_}p Stv P In �y ¢, �w4-c c��ta,C�Ca. ��•"t- IZ-. ZL> 1p VV vv 1 ial i iaNyci TVU w u 10 an 1a1 yv : %-1— w-1 Convicted Dismissed Deferred Suspended Plead Guilty Other 8. Has your driver's license or chauffeurs license been suspended or revoked in the last five years? Type of offense CoIvN. on BO ClL Where When PJ I _ = (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) Z 04/2018 Tgpe, of O+f C C,t "Duk-) 1 — 1Zk-V OV—t,d 1�lOri- P��{ouc GC Ipc Ane, �� II3p��s _ �� z �►5 APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIMD; - DRIVING RECORD MUST ACCOMPANY THIS APPLICATION FOR POLICE CHIW`RgjVIEW You must apply for an individual Department of Criminal Investigation Report (form available ugon request). 1JIS SEI 28 AH i o 09 CIT Y CLERK CITYt ill .': hereby certiffyy that I have issued to me by the Iowa Department of Transportatiq a valid Driver's license number f ,� (j,({( ICA38 issued on `� l6 expiring on Y$�5 I ZQ. 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 pro ' ions of Title 5, Chapter 2, of the City Code. (Needs to be signed in front of a Notary Public) `� Signature of Applicantua2w L, Date "1 2 IR) f1f#f1f111f*#!*'M.##iflfflHHH111f*-11*##*'##!!!#!f!#fliftlf*'*##i##HfM1N1f#*#*##'###f1fHf11NfM1tf**k*#*###i#fifflf!!}fHlflfiflf 11f**#**###f STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by C f%r 4 ttJ Mk • 7c 4_)r on this a-7 day of she--IV_4- z o?7 . . - - .01 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 --�-7 cmet or designee o 1 -or- 7-6 Q -Z 7'Z6'1 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. Office Use Only Approved application DCI report State certified driving record Website update 9 -aF -/ Date a wk/rA%IDRNMADGEAPPL9201Ba.reM .DOC 04/201 WENDY S. MAYER o i Commission Number 729428 y ommis 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 --�-7 cmet or designee o 1 -or- 7-6 Q -Z 7'Z6'1 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. Office Use Only Approved application DCI report State certified driving record Website update 9 -aF -/ Date a wk/rA%IDRNMADGEAPPL9201Ba.reM .DOC 04/201 C 00% 410WA00T SMARTER I SIMPLER I CUSTOMER DRIVEN www,i0wada '&VAM W 09 Dmb #t(v t PD Box gaa„ .r es 4-9 lton Pa 515-244-9t24'1 ao'-61 Certified Abstract of Driving Record Inquiry Date: 9/17/2018 DL/ID #: 136AC0938(IA) Customer #: 5247840 Name: Taylor Crystal Class: C ID Status: VAL JUR Micheli. Revoked 08/30/2012 11/27/2012 A20 Address: 922 BOSTON WAY Audit #: 1203841 DL Status: VAL APT A2 Suspended 02/02/2013 11/03/2015 D53 Issue Date: 08/04/2016 CDL Status: None City/State: CORALVILLE, IA Expiration Date: 08/05/2020 CDL Cert Status: None Revoked 522411266 09/22/2014 A20 Operating While IA IA Endorsements: NONE CDL Med Status: None Mailing Address: 922 BOSTON WAY Restrictions: NONE Restriction None Non -Payment of APT A2 IA Supplement: Iowa Fine Date of Birth: 08/05/1990 Mailing CORALVILLE, IA Sex: F City/State: 522411266 History Information Convictions Citation Date Conviction Date ACD Explanation Coun JUR 08/16/2011 08/10/2012 A20 Operating While Intoxicated Johnson IA Sanctions Type Effective End ACD Explanation Occurrence JUR JUR Revoked 08/30/2012 11/27/2012 A20 Deferred IA Jud ment OWI Suspended 02/02/2013 11/03/2015 D53 Non -Payment of IA IA Iowa Fine Revoked 06/25/2014 09/22/2014 A20 Operating While IA IA Intoxicated Suspended 01/30/2015 11/02/2015 D53 Non -Payment of IA IA Iowa Fine Name: Taylor, Crystal Michelle DL/ID: 136AC0938 Pursuant to Iowa Code §321.10, I, Darcy Doty, Director of Driver & Identification Services, Iowa Department of Transportation, do hereby certify that I am the custodian of the records held by Driver & Identification Services, that this is a true and accurate copy of an officlal 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. FILED 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: Name: Taylor, Crystal Michelle DL/ID: 136AC0938 ,2018 SEP 28 AM I 1109 9/17/2018 CITY C_LEtiPNK �(j{yj,Jj/y 10 WA CI � Y.10` 114, Driver & Identification Services Iowa Department of Transporation Sep,20.2018 9:03AM 0911712018 1322 Yellow Cab Div of Criminal Investigation No. 4621 fW19 338 ZM ILEI $TATY, 01Y IOWA 2118SEP 28 Cflmbuu11B9t6vyRbcord'Cho k' - CITY C, Request Form 110VIA CI T. Tb: T&WA r 1?104r Z1W . & 14'ireot. lyes ralaq, 1GWA .0110 t6tO Fox I Mn WAMesdair " low% CAmin9f.fVMdrvR'AWr& C%&-knw DO AuwitnTNwmber-,, .9967-F (if appliewco From" .�10*.Cab of Idwa 61 r -p- R4 4A 10"efty'.M (319) 338-54777, rao. (aTO) 330-7302 P. 1/7 PAM003 141LOINVOW -V0,H top- "or o\ 081 on C) z2• 9,q ot;m 40M*teic�jnd btstqzy itek =BY *Qt "j be r el e2 a a�, k ger" C. u e-, 04. IQ w C h*jft& 1012;ry r inml ob -.t Om I W h4toryiocurd 14for*ikk as allowed bj, Jaw, always waf4yae.Akk' #'A*" pn tir. rc Roa CP Y. Accord theck RMUW (Da un &W A* Of tw6bof tm- piovided nau;ur aP4 dam of birth revealed' Nq 10;WU C4nined History Record found with.DCI 1;7;' Iowa, Crimmel History Reoord amdhe4J3--60 �;o 1.),:' E3 DO in ifialS 'WI -17 n J T' A. il nAIA 1.nAnkA A. AAlt Se P. 2 0 . 2018 9 : 0 4 A M Div of Criminal Investigation No.4621 P. 2/7 IOWA CRIMINAL HISTORY DCI 00936050 MISDEMEANOR CONVICTIONS ONLY PAGE 1 OF', -2 DATE PRINTEV= ILED 2018/09/20 DCI:00936050 2018 SEP 28 AM 11.09 NAME: TAYLOR,CRYSTAL MICHELLE DOB SEK RAC HGT WGT EYE HAIR SKN POB CITY CLERK 19900805 F W 411 127 BRO BRO FAR IA t {0��lA C{TY.10'I ADDITIONAL IDENTIFIERS PHOTO AVAILABLE! Y TAT L WRS TAT NECK CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 20110616 AGENCY: IA0520500 NORTH LIBERTY PD CHARGE NO- 01 IA STATUTE IA321J.2(A) OPER VEH WH INT (OWI) / IST OFF TRK#: 1A00CHY01 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2(A) OPER VEH WH INT (OWI) / 18T OFF COURT CASE ID: 06521 OWCRO95255 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1ADOCHY01 DRUNK DRIVING SCHOOL LICENSE REVOKED SUBSTANCE ABUSE EVALUATION SENTENCE DISP EFF DAT DEFERRED JUDGEMENT $625 CIVIL PENALTY 20120810 PROBATION lY 20120810 TIME SERVED 2D 20140604 JAIL 41) 20140604 FINE $1250 20140604 REVOKED 20140604 02 ARRESTED/TAKEN INTO CUSTODY 20140412 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 02 IA STATUTE IA715A.8(3) IDENTITY THEFT OVR $1000 TRK#: IAOOIVP02 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE: IA715A.8(3) IDENTITY THEFT OVER $1,000 -- Forgery COURT CASE ID: 06521 FECRIO1655 TRK#: IAOOIVP02 SUBSTANCE ABUSE EVALUATION RESTITUTION SENTENCE DIG? EFF DAT DEFERRED JUDGEMENT CONTINUE MENTAL HEALTH 20150330 TREATMENT PROBATION SY 20150330 SeD,20.2018 9:04AM Div of Criminal Investigation PCI 00936050 PAGE 2 OF 2 No. 4621 P. 3/7 AN ARREST WITHOUT DISPOSITION IS NOT AN INDICATION OF GUILT, THIS RECORD FILED MAINTAINED BY THE IOWA DIVISION OF CRIMINAL INVESTIGATION, BUREAU OF IDENTIFICATION IS A PUBLIC RECORD BUT CAN ONLY BE RELEASED TO NON -LAW 2i3�� SEP 28 AMI1� 09 ENFORCEMENT AGENCIES BY THE DCI. IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD IS CITY CLERK BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD IQ etA CITY. I01%7A', COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION