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Home My WebLink About19-005�AMP-MR ®tl� CITYF IOWA CITY 410 East Washington Street Iowa City, Iowa 52240-1826 (3 19) 3S6-5040 (319) 3S6-5497 FAX Last 1. Name (REQUIRED) IDENTIFICATION NO. Iq - (Office Use nly) APPLICATION FOR TAXICAB / MOTORIZED PEDICAB VEHICLE DRIVER (Police Department rpyiew. nfust be made between 8 a.m. to 3 p.m., Monday - Friday) 1.1, ZUIrJ _, Failure to completehe "required" information will result in denial of the application i First Middle 2. Address (REQUIRED) 2l- SFGO�vd 5`r%1'O B°� /��/A 32445 3. Contact Information (REQUIRED) Email: NNIA4ir-,;& , 4C&'A66Dal Cell Phone: 9Q/ -.2/a Arm (All written coo hmunication sent via email) 4a. Drivers License expiration date (REQU b. Taxicab Business Name (REQUIRED) ) /02.0y -'goza 5. Prior experience in transportation of passengers: 04orwL S Y61C "Vo �gf f.Wl Y Lir ec i Flr'.6 Q¢ dsT,,sx ..sll rw/t - r-oo.D `1tyoeK - MOW /'7G'Dal/rsA+A T64 , �G 6. Have you WAS600 nedydWopW With any n this State or elsewhere? Type of offense - c/r, w ,.l w j4,,.F /hr W he a Gr7 nh� 9,aNy A'%'jV*J. „43sr.�+tls'f .Z��S%r /ewi4' G.� 9 �J .2009 INfl tjf 5�/:1ous I�fS 4 001K ,�lJunDi!leJ w/De�Gl vs tdEaTeu l�tls /Wy What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended Plead Guil Other 7. Have you been arrested / charged with any traffic offenses in the last five years SJ' < Jo ovl•JL P. s.l. , E lul E A.f 20/* �Ul- K � i/ 2008 What happened to the charge? (Circle one) Convicted Dismissed Deferred Suspended J —PleadL�Z Other ,�,,tt 8. Has your driver's license or chauffeurs license been suspended or revoked in the last five years? /v0 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) 04/2018 -- ��NP� � -r,�M .�� 9,� meq, .��;�, ��T Cf.•, . i ` .. .' .. � �.. ..•w ... i« .. t. ... ... .e APPLICATION FOR TAXICAB VEHICLE DRIVER Page 2 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 InveS_#tion, Repor f (fprjn $Veilable upon request). I hereby certify that I have issued to me by the Iowa Departm t of Transportation a valid Drivers license number yz9 ✓✓i23U issued on t/ .1S( expiring on a4-/ - 23 . 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, 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 4,✓. a?�% STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by Fetaa,f t Q 6 ) IT� on this 8 day of in ana for the SWfe of 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 Driver's license -r7 - Signature of Police Chief or designee /Z -0,/-13 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. NE % Gl J. Date Office Use Only Approved application DCI report State certified driving record Website update Clerk/iAXIDRN ADGEAPPL9201Bementled.DOC 04/2018 121De�-26.2018 12:36PMcab r DCI IOWA ffAX)31933B2N.o.6641 P. 1011002 STATE OF IOWA ' Criminal History .Ri�drd 'CHek. l Request Forin l,. To: Iowa Division o(Criminallhvesetgation Support Opera tions • Bureau, In Floor 215 R. 7m Street Des Moines, Iowa 503I9 (515) 725.6066 (515) 925-6080 Fax tT Z Pi 1.2- - Oy- /9_Sq 1-'-: ®Male DCI Account Number: 9967-F (if applloable) From; Xellow Cab of Iowa City P.O. Box 428 Iowa City, a 52244 (319) 338-9777 Phono• gam: 19) 339-7302 I'e, ❑IFetuale I1 lq / ✓!�" 3) 3.,3 Waiver Arnformadon. Without a Signed "'elver from the subject of the request, s complete criminal history record tva not be releasable, Per Code otlowa, Chapter 692.2. For &omalete criminal hlatoryrecord information, as allowed by taw, glways obtain a waiver signature from the subiEct:nrth.......ef Waiver Aeea$e; (hamby jive pennlulon fbr thYabeve nquytlna ofoolai to conduol an Iewa criminal bbtoty tooad ohmk with the Division of C.iminel Invutipdon (DCT), Ally odtnlnN hlstpty detgcon�eepm(n,,j/mo thu t isme/inuinW by the O Mny be mIcsxA as*allowed bylaw, Waiver Sferearse.►e- Jt.tr/.?. le '2�l As of lz 2 6 a a search of the provided name and date of birth revealed: No Iowa Criminal M$tory Record found with DCT Iowa Criminal History record attached"Do # DCI illitialtC. C,' =- DCI -77 (08/25/10) Received Time Dec, 20. 2018 -3:52PM No, 6222 Dec. 26. 2018 2:36PM DCI IOWA No, 6641 P. 2 IOWA CRIMINAL HISTORY FELONY CONVICTION DCI:00776527 NAME: CONNOLLY,ROSERT RAYMOND CONNOLLY,ROBERT RAYMOND JR DOH SEX RAC HGT WGT EYE HAIR 19591204 M W 509 172 BLU BRO ADDITIONAL IDENTIFIERS SC HEAD TAT CHEST TAT UL ARM TAT UR ARM PHOTO AVAILABLE: Y CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 20060518 AGENCY: IA0520000 JOHNSON CO SO CHARGE NO- 01 IA STATUTE IA708-6 '"INTIMIDATION W/DANGEROUS WEAPON TRK#: 101868501 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE. IA708.6-2 INTIMIDATION WITH A DANGEROUS WEAPON COURT CASE ID: 06521 FECR076027 CHARGE CLASS: FELONY CONVICTION TRK#: 101868501 SENTENCE DEFERRED JUDGEMENT $750 CIVIL PENALTY PROBATION 2Y SUPERVISED PROBATION TO DCS FINE $750 SUSPENDED PRISON 5Y PRISON 5Y PROBATION UPON 3Y REVOCATION OF DEFERRED JUDGMENT REVOKED IMPOSED 5Y 02 ARRESTED/TAKEN INTO CUSTODY 20080911 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA321J.2(A) e -OPER VEH WH INT (OWI) / 18T OFF TRK#: 1A0053NO1 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2(A) OPER VEH WE INT (OWI) / IST OFF COURT CASE ID: 06521 OWCROB4680 CHARGE CLASS: MISDEMEANOR. CONVICTION TRK#: IA0053NOI DCT 00776527 PAGE 1 OF 4 DATE PRINTED - 2018/12/2f— 11— E F) 2019 AN —8 Pii I: 18 SXN POB DISP EFF DAT 20070914 20070914 20090213 20090213 20090213 20090213 20090213 20110628 Dec.26.2018 2:36PM DCI IOWA DRUNK DRIVING SCHOOL SUBSTANCE ABUSE EVALUATION RESTITUTION SENTENCE SUSPENDED JAIL 173D JAIL 180D FINE $1250 PROBATION 2Y. IMPOSED 173D REVOKED 03 ARRESTED/TAKEN INTO CUSTODY 20090909 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- 01 IA STATUTE IA716.3 CRIMINAL MTBCNIEF 1ST DEGREE - 1978 TRK#: lAO070MOI CHARGE NO- 02 IA STATUTE IA708.4(2) `-1iLLFUL INJURY - CAUSING BODILY INJURY TRK#: 1A007OM02 CHARGE NO- 04 IA STATUTE IA321J.2(2) ,-,*PER VEH WH TNT (OWI) / 2ND OFF TRK#: 1A0070M04 COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA716.4 CRIMINAL MISCHIEF 219D DEGREE - 1978 COURT CASE TD: 06521 FECR088338 CHARGE CLASS: FELONY CONVICTION TRK#: lAO070MOI RESTITUTION SENTENCE FINE $750 SUSPENDED FINE $750 PRISON 5Y COURT DISPOSITION AGENCY: ZA052015J JOHNSON CO DIST COURT COUNT NO- 02 TA STATUTE: IA708.2(1) ASSAULT INTENT TO INFLICT SERIOUS INJURY -1978 COURT CASE ID: 06521 PRCROO6338 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1A0070M02 RESTITUTION SENTENCE FINE $625 SUSPENDED FINE $625 PRISON 2Y COURT DISPOSITION DCI 00776527 PAGE 2 OF 4 DISP EFF DAT 20090205 20090205 20090205 20090205 20091201 20091201 DISP EPF DAT 20110628 20110628 20110628 DISP EFF DAT 20110628 20110628 20110628 No. 6641 P. 3 Fi{ ED 1019J�t!—g P;! i� 18 Dec. 26. 2018 2:36PM DCI IOWA No. 6641 P. 4 AGENCY: IA052015J COUNT NO- 04 JOHNSON CO DIST COURT IA STATUTE: IA321J.2(B) OPER VEH WH INT (OWI) / 2ND OFF COURT CASE ID; 06521 FECROes338 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#: 1A007OM04 LICENSE REVOKED RESTITUTION SENTENCE JAIL 6M FINE $1875 04 RECEIVED 20110626 AGENCY: IA052015M OAKDALE IMCC CHARGE NO- 01 IA STATUTE IA690.4 CUSTODY IOWA DEPT OF CORRECTIONO TRK#: CBOOC4GO1 INMATE #: 6793503 CUSTODY AGENCY: IA077015C ADULT PAROLE SVC A 20120425 PAROLED CUSTODY AGENCY: IA077015G ADULT PAROLE SVC B 20130407 DISCHARGED DCI 00776527 PAGE 3 OF 4 DISP EFF DAT 20110628 20110628 2019 JAPE —8 Phi 1: 18 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. This response can only include public criminal history data. Under Iowa law, most juvenile records are confidential. confidential juvenile court records, if any, cannot be included in this response. A signed release authorization is not sufficient to obtain this information from the Division Of Criminal Investigation. In order to request the release of confidential juvenile records, if any, an application must be filed pursuant to Iowa Code section 232.147(18). Additionally, criminal history data concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex Offender Registry: http;//www.iowasexoffender.com/ . However, even though some information is available on this site, the actual records for juvenilaa may stili be confidential and any confidential juvenile records cannot be provided with this record. In order to request the release of confidential juvenile records, if any, an application must be filed pursuant to Iowa Code section 232.147(181. 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, C1_ .i Dec. 26. 2018 2: 36 PM DCI IOWA No. 6641 P. 5 DIVISION OF CRIMINAL INVESTIGATION 71LEr) Z019 JAH CC"-..- CIOWA DOT I L E O SMARTERISIMPLER ICUSTOMER DRIVEN ,A,w,A,iowadot.gov WORK iIOMtlflDWofl SINVICK Po 8w 920/ 1 Da MDIne3. 1A 5090&9201 2D19 _��!! -� ('ii 1= 8 PIId1C. 51'5244-91741 Fait: 515.239-1937 Inquiry Date: 1/2/2019 Cuatomer p: 2681025 x.me: Chorally, RpWrc Raymond 28 Aaeren: 215ecor i St Ayt 2 aty/State: Hata, IA 52135 MaiOng Address: pO BO%) Mailing City/State: HILLS, IA 522350007 Data of Birth: IL4/19% Sex: M ConviNons CertlHetl Abstract of Driving Record DL/ID 0: 42906230 (LA) Class: D Audit a: 3349226 Issue Data: 11/01/2018 Eapintlon Data: 12/04/2023 Druid- mens: Chauxeur3 Restrictions: Cmetllve Lentis Restriction More wpplenrm: Johnson History Information Cot permit Clnu None CDL permit Issue Date: None CDL permit Expiration Date: None CDL permit Endorsements: None COL permit Restriction.: None to statue: Nmle DL State: VAL CDL forcu.: Mare CDL permit Statue ELG CDL 4tl 5btn: Hone Col. Nee Status: None flatten D. conNctlon late ACD UPI a.Hlon MR Wunty 9/11/2000 02/05/2009 Q. OperaOng Wale Intoxicated In John. 9/09/2009 06/28/2011 p o Ope:atln9 Wre, Int. l'Ddod IA Johnson 5/08/2010 06/ll/2018 592 Speed le Johnson OCeratiog While intoxicated Test Refusal/Tett Failure violations 1-a,,nce ACO Explanation JUR County 19/11/2008 q98 OWI Test Failure IA Johnson 19/09/2009 A98 OWI Test Failure IA Johnson Accidents - Accident Involvement Indicatal does NOT mean the Individual was at fault or given a citation. A¢Mant Date Me Case Number 05/16/2015 LA 859386 Sanctions 'ype E1M1el End ACD Explanation JUR Oxumnw NR .evokee 09/22/2008 03/20/2009 A98 OWI Test Failure IA 1A niquallRed 111/11/2008 10/10/209 A98 OWI Fast Failure IA LA early. 12/09/2009 12/03/2010 A98 OWI Test Falms W IA Me—: Conrolry, Robert Reymond JR DL/ID: 429W6230 (IA) Panama to Iowa Cade §321.10, 1, Darcy Doty OSHA R Ideatinvoluon Services, Iowa DewmnnR or Trare,dr, atbn, do Parker mUry knew I am UM artodan orthe nature, hdd by crime a IdmU0 Servlsxs, tical Is Is a Hue aM actuate copy or an omaal record amnny In me m ody or said oma, and mat I have Oda: aulsmnend In the pnaor or the home DelwM1mmt m TnmportaNen W W com". In witness whereat, l have caused my signature and the seal of the Department to he set upon this document, at Ankeny, Iowa this data Name: Connally, Robert Raymond IN Ol/I0: 429%6230 (IA) A2 \��1/2/2019 l VL OV, Driver R Ida tlOcatlon Services 1 D0C Iowa Departlllom of TrampMetlou Name: Connally, Robert Raymond IN Ol/I0: 429%6230 (IA) i 199 sPr IOWA 4,z- 2Q14 JSP! -8 PPt its INTlroipn'.�wn/ w vr�A od (IT 4�• QO - I6W I"j I lGA IoW is's 46 IJeTE:Ub tio je9d ort E & erre- O. amid A Itoorwp+wr`.,'ClwAS WNW 4E IM Slrj iAof A4 it 5 .4'1T , eF woe �1 �v+ `►�oV� ovr1� ,N 'Q� �iigjl' pP SAN 8 � �GcIC. 4 A RWOOI,6 M ie ISR 16 u� 3: 9m rl omn�i& � w/o+�4D Glp.,osf1�. W- Ao? N Aj wlo(�rf ^A P4 '1 f ��f�� Isla AV-OAL. AI., N�,MOA M10NY Cq w (Py Ifi 1Ko11}i -S 6vyK -� �rs��J ns .�N�h.a��_� yor5� b SV �} �°� °.2'• ��si� y4r+NF1� S /"WVr4tA1 j$o � y✓ � ��ier i� r„ r Ilo ,n .,wb N, �N, �� ,,� ,��,�,y`i� y°N �,d y _ -2 N !O q, iY' lL.+/A2p„F 041 AYR f� V- YY MOA SCJ, j�q�� b '.a5 Q" -$40 ► y� •R,m'jw N!� ►�� 1' SN '1'b • t* wo M02 F300-21 OtIoloil M — !MO Vow Aam Y lwZ asy&-5 �v