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HomeMy WebLinkAbout21-0011 t t CITY OF IOWA CITY 410 East Washington Street Iowa City. Iowa 52240-1826 1319)3S6-5040 (319)3S6.5497 FAX 1. Name (REQUIRED) 2. Address (REQUIRED IDENTIFICATION NO JAI tori 2► — cl-�G l (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 applicatior Last First Middle 3. Contact Information Email: L4 ' 4sc5f�hnEdl946M6. 4et Cell Phone: Q01- 1 to - `(s66 (All written ommunication sent via email) 4a. Drivers License expiration date (REQU b. Taxicab Business Name 'tFOUIRFD) 5. Prior experience in transportation of passengers: NjG rri CR$ De VGR SuMn605, 6. Have you ever been arrested /charged with any misdemeanors and/or felonies in this State or elsewhere? Type of offense Where When A Irff1r4%Wos1 I we464 Aar, �Qinsorl Coa,'Y nur�, aoa6 Dfflrtx€l, :!NV-refaf , ytzy. TRDN)to 6 C Wh (circle one) Convicted Dismissed Deferred Suspended Plead Guilty Other 7 Have you been arrested ! charged with any traffic offenses in the last five years? Tyne of offense Where When SPqJD,jC 4 b� Cael�dlt: MAS )sl What happened to the charge? (Circle one) Convicted 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? me) 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) IAD (SECOND PAGE FOR REQUIRED SIGNATURE AND NOTARY) 04/2018 Page 2 APPLICATION FOR TAXICAB VEHICLE DRIVER DEPARTMENT OF CRIMINAL INVESTIGATION (DCI) REPORT AND STATE CERTIFIED JAN 8 2g2) 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) I hereby certify that I have issued to me by the Iowa NDep tment of Transportation valid Drivers license number 2q /Y b.Z 3D issued on II 1 1 expiring on) 01 I understand that if I a falsely answer any questions in this application, that this li tion may be denied.Vagreb 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 obi` / . ✓/Af)T_ Date t �l STATE OF IOWA ) COUNTY OF JOHNSON ) Subscribed and sworn to before me by on this day of Notary Public in and for the State of Iowa fMRlflffffifHlf#iM}RlRilff1f1f1f1flff1f1f1fffffHllXflff1111XR1X1f41fffflf!!!t1!}!t!}!}t}ttX}f}}RHRRttRMRltl4flfffflNlff Mflf1X11tlflffflN 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 I L- d u 7_S dl a� Z) Signaffrd'o-f 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. Office Use Only Approved application DCI report State certified driving record Website update ©I— cJR -2-o -)—I Date CbM JORIV DGWPBM18yne,ded. DOC OM18 ILf�..M�� ..IL. .w�•: hvl ,I MNIi .MI t. fVW I ,Wdlnrfr 'i �> 11 1 i 1 I,%�Iecord Check .'.,' Mall or Pax cumble.5d forma to Iowa DivWoa of Criminal Investigation Support Operatiow Urtall, 1" Floor 215 E. 7* Street Des Motnel, Iowa 50319 (515)725.6066 (515)725-6080 Fax DCI Account Number; 9967-F (ifIMlln61e) Send rosults to: N■mo YGUOW Cab of Iowa CUy Addrets P.O.Boz428 l aw& City Iowa 52244 Phone (31P) 33M777 - Fox 319-3594141 DCI -77 (updated 06-26-2018) Page 1 oft Received Time Dec. 21. 2020 2:53PM No.7901 IOWA CRIMINAL HISTORY FELONY CONVICTION DCI 00776527 PAGE 1 OF 4 DATE PRINTED - 2020/12/23 DCI;00776527 NAME; CONNOLLY,ROBERT RAYMOND CONNOLLY,ROBERT RAYMOND JR DOB SEX RAC HGT WGT EYE HA --R SKN AGO 19591204 M W 509 172 BLV BRO NJ ADDITIONAL IDENTIFIERS PHOTO AVAILABLE, Y SC HEAD TAT CHEST TAT UL ARM TAT UR ARM. JAN 8 2021 City Clerk Iowa City, Iowa CCH RECORD *** 01 ARRESTED/TAKEN INTO CUSTODY 20060518 AGENCY. IA0520000 JOHNSON CO 50 CHARGE NO- 01 IA STATUTE IA708-6 INTIMIDATION W/DANGEROUS WEAPON TRK#: 101668501 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 PECR076027 CHARGE CLASS: FELONY CONVICTION TRK#: 101868501 SENTENCE DISP EVP DAT DEFERRED JUDGEMENT $750 CIVIL PENALTY 20070914 PROBATION 2Y 20070914 SUPERVISED PROBATION TO DCS FINE $750 20090213 SUSPENDED PRISON 5Y 20090213 PRISON 5Y 20090213 PROBATION UPON 3Y 20090213 REVOCATION OF DEFERRED JUDGMENT REVOKED 20090213 IMPOSED SY 20110628 02 ARRESTED/TAKEN INTO CUSTODY 20080911 AGENCY: IA0520200 IOWA CITY PD CHARGE NO- Ol IA STATUTE IA321J.2(A) OPER VEH WH INT (OWI) / IST OFF TRK#: IA0053NOI COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA321J.2(A) OPER VER WR INT (OWT) / 18T OFF COURT CASE ID! 06521 OWCROB4680 CHARGE CLASS. MIS02MEANOR CONVICTION TRK#: lAO053NOI JAN 8 2021 City Clerk Iowa City, 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 MISCHIEF IST DEGREE - 1978 TPX#: IA007OMOI CHARGE NO- 02 IA STATUTE IA708.4(2) WILLFUL INJURY - CAUSING BODILY INJURY TP.K#: 1A007OM02 CHARGE NO- 04 IA STATUTE SA321J.2(B) OPER VEH NH INT (OWI) / 2ND OFF TRK#: 1A007OM04 COURT DT9POSTTTON AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 01 IA STATUTE: IA716.4 CRIMINAL MIOCHIEF 2ND DEGREE - 1978 COURT CASE ID; 06521 VECK088338 CHARGE CLASS: FELONY CONVICTION TRK#: IA007OM0I RESTITUTION SENTENCE FINE $750 SUSPENDED FINE $750 PRISON 5Y COURT DISPOSITION AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 02 IA STATUTE: IA708.2(1) ASSAULT INTENT TO INFLICT 8ERTOU9 INJURY -1978 COURT CASE ID: 06521 RECROBS319 CHARGE CLASS: MISDEMEANOR CONVICTION TRK#+ I.A007OM02 RESTITUTION SENTENCE FINE $625 SUSPENDED FINE $625 PRISON 2Y COURT DISPOSITION DCI 00776577 PAGE 2 OF 4 DISP EFF DAT 20090205 20090205 20090205 20090205 20091201 20091201 DISP EFF DAT 20110528 20110629 20110628 DISP EFF DAT 20110628 20110628 20110628 JAN 8 ppyj City Clerk Iowa City, Iowa AGENCY: IA052015J JOHNSON CO DIST COURT COUNT NO- 04 IA STATUTE: IA321J.2(B) OPER VEH WH INT (OWI) / 2ND OFF COURT CASE ID: 06521 PECRO88118 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 CORRECTIONS TRKA: CE00C4GOI INMATE q: 6793503 CUSTODY AGENCY: IA077015G ADULT PAROLE SVC A 20120425 PAROLED CUSTODY AGENCY: IAD77015G ADULT PAROLE SVC B 20130407 DISCHARGED DCI 00776527 PAGE 3 OF 4 DISP EFF DAT 20110628 20110628 JAN 8 1021 City Clerk Iowa City, Iowa 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, moat 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(10). Additionally, Criminal history data Concerning convictions for certain juvenile sex offenses can be found on the Iowa Sex offender Registry: http://www.iowasemoffender.com/ . However, even though some information in available on this site, the actual records for juveniles may still 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(18), IN THE ABSENCE OF FINGERPRINTS FOR POSITIVE IDENTIFICATION THIS RECORD I6 BASED ON INFORMATION FURNISHED. WE CANNOT CONFIRM OR DENY THAT THE RECORD COVERS THE SUBJECT OF YOUR INQUIRY. DIVISION OF CRIMINAL INVESTIGATION FILE JAN 8 1011 City Clerk Iowa City, Iowa C,i'u► DOST SMARTER I SIMPLER I CUSTOMER DRiVEif www-lowadot.gov OW.ar R ItlaatiBeatiOa SMWeet PO Box 92041 Iles Morris& IA 503064!20+ Phoria rll-744.9124IFax 5M -22A-1837 Certified Abstract of Driving Record Inquiry Date: 1/4/2021 DL/ID #: Name: Connolly Robert Raymond JR Class: Address: 21 Second St Apt 2 Audit #: 11/01/2018 CDL Status: Issue Date: City/state: Hills, IA 52235 Expiration Date: Chauffeur 3 CDL Med Status: Endorsements: Mailing Address: PO BOX 7 Restrictions: Speed Supplement: Date of Birth: Mailing Qty/state: HILLS IA 522390007 Sex: Convictions 429VV6230 (IA) Customer #: 2681075 D ID Status: None 3349226 OL Status: VAL 11/01/2018 CDL Status: None 12/04/2023 CDL Cert Status: None Chauffeur 3 CDL Med Status: None JAN 8 2021 Corrective Lenses Restriction None Speed Supplement: IA 12/04/1959 _.. N _. History Information Citation Date Conviction Date ACD Explanation County JUR 09/11/2008 02/05/2009 A20 Operating While Intoxicated Johnson IA 09/09/2009 06/28/2011 A20 Operating While Intoxicated Johnson IA 05/0812018 06/11/2018 592 Speed Johnson IA Accidents - Accident involvement indicated does NOT mean the individual was at fault or given a citation. Accident Date I Case Number JUR 101/22/2019 1092929 IA Operating While Intoxicated Test Refusal/Test Failure Violations Sanctions Type Effective End ACD Explanation Occurrence JUR JUR Disqualified 10 11 2008 10/10/2009 A98 OWI Test Failure IA IA Revoked 12/09/2009 112/03/2,010 A98 I OWI Test Failure I IA IA Name: Connolly, Robert Raymond JR DL/ID: 429W6230 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 We 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: 1/4/2021 «J� Driver & Identification Services Iowa Department of Transporation Name: Connolly, Robert Raymond JR DL/ID: 429W6230 JAN g P011