The URL can be used to link to this page

Home My WebLink About2005-12-13 Appointment ~ NOTICE THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING COMMISSION: AIRPORT COMMISSION One Vacancy - Unexpired Term Ending March 1, 2010 Duties: To exercise all the powers granted to cities and towns under Chapter 330 of the Code of Iowa, except the power to sell said airport. To annually certify the amount of taxes within the limitations of the Statutes of the State of Iowa to be levied for Airport purposes. All funds derived from taxation or otherwise for airport purposes shall be under the full and absolute control of the Airport Commission, deposited with the City Treasurer, and disbursed only on the written warrants or order of the Airport Commission. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Airport Commission meets the second Thursday of each month at 5:45 p.m. Applications must be received by 5:00 p.m., Wednesday, December 7,2005. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Airport Commission should be directed to Randy Hartwig, Airport Commission Chair at 337-2101. ~i~pi!'t~ Commission ATTENDANCE RECORD YEAR 2005 IMeetine Date) TERM 1/1 2/10 2/16 3/10 4/1 5/12 6/9 7/14 8/11 9/8 10/13 11/10 NAME EXP. 3 4 Daniel Clay 3/1/08 0/ X X X X - --- 0 - - - -- E Randy 3/1/09 X X X X X X X x X X X X Hartwig Greg Farris 3/1/07 -- --- -- -- -- -- -- X X X X X John Staley 3/1/06 X X X X X X X X 0 X X X Carl 3/1/10 X X X X X X X 0 0 X X - Williams Howard 3/1/08 -- - -- - - - - X X X X X Horan KEY: X ~ Present o = Absent OlE = AbsentlExcused NM = No meeting -- = Not a Member Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in-law, sister- in-law, step-father, step-mother, step- child, aunt, or uncle. (Resolution 85-354) Males: 4 Females: 0 Council Announcement Date: November 1, 2005 Application Deadline: Wednesday, 5:00 p.m.. December 7, 2005 Council Appointment Date: December 13, 2005 AIRPORT COMMISSION One Vacancy - Unexpired Term Ending March 1,2010 (Carl Williams resigned) No applications as of Wednesday, 5:00 p.m., December 7,2005. [8J Denotes applicant completed the Confidential page of the application. _.._~_._._-._,------"--"--'--'-------"--"----"-~~-~--~---,,-,,"_._..._.__.'--'--- ~ L.1iJW NOTICE THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy - Unexpired Term Ending December 31, 2006 The powers and duties of the Airport Zoning Board of Adjustment are: 1. To hear and decide appeals where it is alleged there is an error in any order, requirement, decision, or determination made by an administrative official in the enforcement of the Airport Zoning Chapter. 2. To hear and decide special exceptions to the terms of the Airport Zoning Chapter upon which such board is required to pass under the Airport Zoning Chapter. 3. To authorize upon appeal in specific cases such variance from the terms of the Airport Zoning Chapter as will not be contrary to the public interest, where owing to special conditions a literal enforcement of the provisions of the Airport Zoning Chapter will result in unnecessary hardship, and so that the spirit of the Airport Zoning Chapter shall be observed and substantial justice done. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets at the call of the Chairperson. Applications must be received by 5:00 p.m., Wednesday, December 7,2005. The City Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Johnson County/Iowa City Airport Zoning Board of Adjustment should be directed to Randy Hartwig, Airport Commission Chair at 337-2101. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step- child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: 0 Council Announcement Date: March 16, 2004; May 4, 2004; June 15, 2004; August 3, 2004; September 14, 2004; November 2, 2004; December 7, 2004; January 18, 2005, March 1, 2005; April 5, 2005; May 17, 2005; July 5,2005; August 16, 2005; September 20, 2005; November 1, 2005. Application Deadline: Wednesday, 5:00p.m., December 7,2005 Council Appointment Date: December 13, 2005 AIRPORT ZONING BOARD OF ADJUSTMENT One Vacancy - Unexpired Term Ending December 31,2006 Carl Williams resigned No applications as of Wednesday, 5:00 p.m., December 7, 2005. IKI Denotes applicant completed the Confidential page of the application. ~ NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING COMMISSION One vacancy - Six Year Term January 1, 2006 - December 31,2011 Duties of the Airport Zoning Commission are: 1. To recommend amendments to the current Iowa City Airport Zoning regulations, including the repeal thereof. 2. To recommend the adoption of new Airport Zoning regulations. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets as required. Applications must be received by 5:00 p.m., Wednesday, December 7, 2005. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Airport Zoning Commission should be directed to Randy Hartwig, Airport Commission Chair at 337-2101. Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mother, step- child, aunt, or uncle. (Resolution 85-354) Males: 4 Females: 0 Council Announcement Date: September 20, 2005; November 1, 2005 Application Deadline: Wednesday, 5:00p.m., December 7,2005 Council Appointment Date: December 13, 2005 AIRPORT ZONING COMMISSION One Vacancy - Six-year Term January 1, 2006 - December 31, 2011 Term expires for Mark Anderson No applications as of Wednesday, 5:00 p.m., December 7, 2005. [R] Denotes applicant completed the Confidential page of the application. /:;1.-13 05 I q d. NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: ANIMAL CARE AND ADOPTION CENTER ADVISORY BOARD One vacancy - Three Year Term January 1, 2006 - December 31, 2008 The Animal Control Advisory Board shall provide such recommendations and advice as are required by the 28E Agreement between the City of Iowa City and the City of Coralville, or as may be requested by the City Council or City Manager of Iowa City or by the City Council or City Administrator of Coralville. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. Applications must be received by 5:00 p.m., Wednesday, December 7, 2005. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Animal Care and Adoption Center Advisory Board should be directed to Misha Goodman, Animal Services Division Supervisor at 356-5295. ------~--_.._.._----_.~_.__.__.,--,.~.- --'---'--'--~-" -------_.._~.__._._-_._._--------_..._- ~,-_..._.".,.__.- .. ._..._-_.-..__..-..._,-,_._-------,._"-,,._._-_.-....~.----- , Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 2 Females: 2 Council Announcement Date: September 20, 2005; November 1, 2005 Application Deadline: Wednesday, 5:00 p.m., December 7,2005 Council Appointment Date: December 13, 2005 ANIMAL CARE AND ADOPTION CENTER ADVISORY BOARD One vacancy - Three Year Term January 1, 2006 - December 31, 2008 Term expires for Tammara Meester No applications as of Wednesday, 5:00 p.m., December 7,2005. !Rl Denotes applicant completed the Confidential page of the application. / ;;l-) 3-05 I q €- NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF APPEALS One Vacancy - Unexpired Term Ending December 31, 2008 It is the duty of members of the Board of Appeals to hold appeal hearings on matters concerning the Uniform Building Code, Uniform Plumbing Code, National Electric Code, Uniform Mechanical Code, Uniform Fire Code, the Dangerous Building Code, and the Iowa City Housing Code. Members must be qualified by experience and training to pass upon matters pertaining to building construction. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Board meets the first Monday of each month at 4:30 p.m. or at the call of the Building Official. Applications must be received by 5:00 p.m., Wednesday, December 7,2005. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions regarding the Board of Appeals should be directed to Tim Hennes, Sr Building Inspector at 356-5122. BOARD OF APPEALS 12 MONTH ATTENDANCE RECORD 01l()1/05 to CURRENT Meeting Date W"YJl~ Jqnn GlIW'.Ha1;gan ""na aliS$ St~"'e OOHsl"s Tim Flint "'~as Roffman BUlll!:hlilg Oq~~lll'1Tle 1/10/2005 X X X X X O/C O/C 5/2/2005 X X X O/C X X X 5/24/2005 X X X X X X X (X) = Present (0) = Absent (O/C) = AbsenUCalled (Excused) Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in-law, father. in. law, brother, sister, brother. in-law, sister. in-law, step-father, step. mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 6 Females: 0 Council Announcement Date: November 1, 2005 Application Deadline: Wednesday, 5:00 p.m., December 7, 2005 Council Appointment Date: December 13, 2005 BOARD OF APPEALS One vacancy - Unexpired Term Ending December 31,2008 Anna Buss resigned C. Wayne Maas 1122 Hampton Ct liS] (Currently serving 2nd - 5 yr term) Chad Campion liS] 3114111 Ave liS] Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLlCA liON FORM I ~ I -,.....= -~... A:~~!:"t. -..;;.... . --r" ....,..---.... 'l CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONFIDENTlAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME R l:J <I {' d. NAME (J,llt<. <' I"'? <:: 1,),Q..:3 1A.,.'" J1?,-r IT.. " HOME ADDRESS 1/.;l.::J. .4'dYW"p7'ii><:> el_ ls your home address (listed above) within the corporate limits of Iowa City? ,., -9- Af f <2.a. { :$" TERM 5" ')Pd..<: I2SJ Yes ZIP :5 ;:;)::J L/ !J DNo 'JCCUPATION ;::/~/ hi',.. ,'ti!~ /S\)-<l<l.ry EMPLOYER P,e t' .. 'S: l\~),C EI e Cot;.. \' L How long have you been a resident of Iowa City? PHONE NUMBER: HOME :'-./9 - 3' 3 '/-;}.D'-;-..-( BUSINESS 3/9- 33~ - Of :J ~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ;;::. hao "- /"~.e..", .'",,""1k._ <:.ONS't<''"'"<''(",'''' '^- ,'lOda."St~ all",-9 ""'~ (;fe d""et MU<L a '3,"'0.,[ ba<...k,,\<-oc.l.>u<t 09 tJl/<1.<;'f'<Lc.T:-.s ",~ <!<">><>:rtr-u.<:.1l-~ 2'\- _ :r h..au ~ seru....( <l/1) 1,(..... 6",,,....."'. p,... . u."l"7- + (~ " .i - 1 I ~O,d ~~. - c:....... Q /J'?a:Sf"-"f' <2. eelrJ <:.,0......... ( I ce>os-<:!i IV\) :;rOOJd C:Ttl as (-'0",-1/ d~ e>T4............ 3"u:.....r-6l.../. ./, j co.~ .fT. .:J ~ ,,..,... ~ /l-, u...., '" ~ o ~ -..). ~O g -l -t 11 0-< I - --, .::- r -0 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? :x X /-va" e. " U6"3'1::: k,""'6""'(-ed<:{..... 6(' tA-'<.o -60(1,...,{ 0:5 :r h.<Jv...... fer-:::i)-e..,{ ...'" /''It,-,- -~ . ~ .::- bo<sr-:d S" ,.., <::..... 199<( """d:z:: a..... <:,u"'T"<!".;,"1 (~ G; e. -<. - t:."-.dt -r- . -' Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions. Council may not consider your application. General Application February 2005 Page 1 of 7 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR \PPL YING)? w;-/i.... tll~ e..O~:stru..dlOY0~bQ.~k~C-OU7'>d ) k.nJC>Vv('<-.l.~......... of! i.4.'(., t!tJd"-'"S) oN</, 'P1'€..o,' ...u-.~ e..><.\l-e....~-<2.""'<::.e. 6"" 71t-....... 66 ct nl I ~e...i I d""'- c;l "0 <1';5Se...t- ;h..> '<i!..U-s.-[(.I..(J-f,'lA:>,\ F"obt'e."'^-S' &.ou t,.-t:. te, tit-...... I.x,df'd..~ W"U./.,({'6'f''''-<il'\:> ~' / ' ~ P 2{ (.c.1O lo..Se.<I t>~,h,c'o,^" <::6""e.......,..N\'~"l T4'L'S ("'0 D -e..PV'\....~ - 6l:> / U "<- +~ ,...L.. Y>1j '::Ie-41'S <!II'\) 7l:.e 064...'/ X"- n "....., ~ S6""....(I'.~_ -.lJ 1.'/ l 6,",~,...ou..""4(~r ""'''-~ z..:> .7" " S 1'2-1... { ~".,."'" d' . O~ <:1,... .....~><(.. /..0"'-. "'I' ~ ab ('""<... to ~~~~ ...;~~ ,.,,... ~o')~,<-"'ST,-.. "'- be.c.<,,,,,-e. cOd"€- <:.O"'l..\,l.'o,^-_l::. ' ~ "'- a ~~~{(a",-i:- POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a'board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. - g o ~ 11 I .,... )>~ --. 0--< -;,.-., -')C / .-<.. m -::0 0:;,,: ~ "" 3: ...- \ m r-l v .,... IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~YES DNO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? D YES ~ NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application.s General Application February 2005 Page 2 of 7 BOARD. COMMISSION. & COMMITTEES BUSINESS LISTING I! I -~= -IQ' !:~~!:'t -..;;:,... .....t'- ---~ .. CITY OF IOWA CITY Name of City / Board/Commission R,., (l r A 6 Q II y r ~<l. :J Name (',hdr-('-fL"i. {./)dj.o-e mClCl.'S. Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). Date 10-'(-05" list all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, Pilrtner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS r ...., => = ~o 0 0) A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. g;/~ ~r~AM //.:;;;;. #t1frte/'?;"'o. ~I';.J :c.oLOd ~'-j ""::> ~'7'("'l Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. NOTE: Signature Address General Application February 2005 Page 3 of 7 CITY OF IOWA CITY ADVISORY BOARD/COMMISSIQ! j "'PLICATION FORM International Brotherhood of Electrical Workers LOcal 405 .'1""" CHAD CAMPION Assistant Business Agent I Organizer .~- 1211 WILEY BLVD. S.W. 412 HIGHLAND AVENUE Individuals serving on Boards/Commissions play an impo CEDAR RAPIDS, IOWA 52404 IOWA CITy' IOWA 52240 PHONE (319) 396-3241 PHONE (319) 337-0499 interest to our community and its future. Applicants must resi FAX (319) 396-3083 E......: coampIonO_405.org After a vacancy has been announced, the Council reviewu \,f,1I ~t"'t"'IIV""L''''''''''' ........I'~ ....... .........n. ...."............,. . I..... appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. ~\'?-i\GIJD o~;<" ~" ,('~\\ ~, c;..,'. ;tt ~:'t ~.'~ ~ 'iI ._;; % ... ~~' .~uJJ'", <;\\"\'f,~.; TH!S APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME ~op,.o" "'~ (4;'PEc:>,-L-:' Youth Advisory Commission, Age on the date of filing: 0 Age 15 to 17 (or) TERM:~1>IIt.I"V~.:(")R = Signature of parent/guardian if Age 15 to 17: o Ag~go 2~ r) -( " -'-. , --I() ....... ~-< r- ~' .'~E C. ~n.l;) c.-ClM~I<:>>J HOME ADDRESS ~\\ 0:0 :r; 0 ~x is> w L.\ T \-\ jlI.vE ZIP ~Yes - 52.7...., S' ONo Is your home address (listed above) within the corporate limits of Iowa City? . How long have you been a resident of Iowa City? _'?l 4. F;;Ct.i2.. "- OCCUPATION ----.&'1 ~"":N)..1C.I~N EMPLOYER 'X(4;:...) L.r.c.A. &"105" PHONE NUMBER: HOME ~\.9 - ~b"'... "'~..,c. BUSINESS ~\c:,. :,~.., ... Ol-/C!tct EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: \"::> '\EAa.~ 010 EX-PI02..II<r...te..E IN ~f..4STI2..I1c:..7/0N({2.e~I~"T\/l>~, ~~'-) L.JO.) rAIq"...In.(LI''-\ L..l\T\.lo i!>L)\L\)''''c.. c.o~€-::. (L..<.>c..I>IL) lo-lA."T\O.....(>,l. :l:lo.......~...O...1I:I.'-) .. ) Aj..1D c.c,...~"'II'l..;<...--no... M~D~. e..0tuLc-...."'i'U1 t.W....D ~.NOll..(:I.L ""'LCc.....-m..IC:.p..~ Llc.""", ";,c;"S aN;:' ~i:>E c...cn..T.~ 1<.A-"'nc.>I--l'E.. e~I:lC\'LIC\-<L\S ,.:Ao-ttt.t<:. ELec..nl...C,./>..... A;>"I1..c:MT\L.~:;~.? IN- VOLVO::> IN '::.'Pl-"'rE Elic-m..llAL / ~'-"M.~IN4 L.\t,Gr-JSU1U; Ac..-"n",.T\E;c.:.. F~MILI/>.LI""\....""'" ~"'P>"., I..o'-A\- ""'"'0 vof'"'3: :t5SuGS. 1"\ F It.. c.o I~. '2.00~ \\AM! ... AT =. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail ~o answer all the questions, Council may not consider your application. General Application November 2005 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ""€ ~~,1-0 OF P.,,(:l~L.5 1.t->~",ct.tO":::. ~A-"\ (.\L..\\....,.4"'..,..\l0= M.cn'\<>()~ O~ 0.OM.~TQ.",cnOLt Pl{L€ 5A.I"':- /),.v\) ll..€I'r50,.Jl>.-:!,1..€ 'l"V LO><.AL ~,.}C N"(:I.-nol'-'()...~ '- ,06'':) 0.... 0 \2..';;~"u>'-"i'\C>M S. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? J: ~>'\ Ef>l4.ciL"To G..-t.'T ',",,"C>L\,I\..-o n..."n'-" ....G"'Il-~ ()r ~;>;>t'II\L~ 'TO J p.u..O"-' M.J:. "To \o'\E....... OuO- e..c.~"oV C'f"'\ V"" OulL c....'''' c..ovOL"-'M..C\.o\.I) , TO ll-l"::>ulLE l~"~ \L\(....:o E.....T\-\"'::../),~"". u"'OC\'L~'CVV()""c.) U€i).CA-....o...... C\,vi) t:")(PL'1L1Ct--\<...,s \'::. DIlo.Jc....,r. ,0 lot€. ,....~LE. I C>M. Lao"'-'H.G. ~o<U..1~ ,0 ,'lr\€ ~r>.\..\..,"""G..~ 0F ~I"" \ I-lV()LV L'1) w ,<v. ~.~ ~~O P 1">.""'<:) ov.'L U~vl\J '"1'-1. 0 ~o P_-i 0-< ..... = = en = rrt C'") 11 I --1\../ Vl ! C<r' m . rn ""0 I ~:x n advisory boarQ::'aOO }'RSIr personal <: .. )> w POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the interests, including financial interests and your duties to an employer. II. . .uticular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency.Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists. or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's Office at 356-5030. NONE . IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes D No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? D Yes ~ No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail '0 answer all the questions, Council may not consider your application. General Application November 2005 Page 2 of 7 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING I ~ ! -~~ -~... ~~~!:~ --=.... ......~ ....~ CITY OF IOWA CITY Name of City Board/Commission bO~lLC'\ o~ ~PPc:c>.-L-::' Name C/l~~\:) ~Pl0t...1 Date I~ - /-1- oS- Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS t....\ ",..\c . NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. C Applicant Signature C y- :- - Signature of parent/guardian if Age 15 to 17: Address ~U 4"'" f-\vE T o..A (' _,'T'"\ C5 5fQ -, ( '-<:.::' ~ ~ c::. r-r, . ~n a ~ Misrepresentations on this application will constitute just cause for removal of an appoi,,*e. I. yOU/Tait .0 answer all the questions, Council may not consider your application. O;;;Z' ~ cn ~~\ '- ' General Application November 2005 c..> - Page 3 of7 ^_~~U_~___------'..._~~~___.__________~________,___~.~_.___________.__ Page 1 of 1 Marian Karr From: Chad Campion [ccampion@ibew405.org] Sent: Wednesday, December 07,20059:09 AM To: council@iowa-city.org Subject: Appeals Application To the Members of the Iowa City Council: On Tuesday, December 6th, I submitted an application for the Iowa City Board of Appeals. I am applying for the vacated term expiring in 2008. I would sincerely appreciate your consideration in this appointment. If you, or anyone else would like any further information, references, or would just like to chat, please feel free to drop me a line. I can be reached at this email address or by phone, at the numbers listed. Thanks again, I look forward to hearing from you, Chad Campion 319-533-0648 (cell) 319-337-7376 (home) 319-337-0499 (work) 12/7/2005 i:l-i3-CS' /1 -F NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HUMAN RIGHTS COMMISSION One Vacancy - Three Year Term January 1, 2006 - January 1, 2009 The duties of the members of the Human Rights Commission are to receive and to determine the merits of human rights complaints alleging unfair or discriminatory practices in the area of employment, credit, public accommodation, education, and housing. The Commission shall provide conciliation and the enforcement necessary to further the anti-discriminatory goals of the Human Rights Ordinance and to protect citizens from unfounded charges of discriminatory practices. The Iowa City Human Rights Commission has an obligation to investigate and study the existence, character, cause, and extent of discrimination in Iowa City in order to eliminate discrimination by education, conciliation, and/or enforcement. It is also the duty of the Human Rights Commission to draft revisions to the Human Rights Ordinance if necessary to eliminate prejudice, intolerance, bigotry, and discrimination. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Human Rights Commission meets once a month at 7:00 p.m. Applications must be received by 5:00 p.m., Wednesday, December 7, 2005. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Human Rights Commission should be directed to Stefanie Bowers, Human Rights Coordinator at 356-5022. Board or Commission: il'JillillJ Wl;i!#j! ATTENDANCE RECORD YEAR 2005 (Meeting Date) TERM NAME EXP. 1/25 2/22 3/22 4/26 5/24 6/21 7/26 8/17 8/23 9/27 10/25 11/22 12/27 Lisa Beckman 111/07 X X X YA DIE NMNO X X X X DIE Paul Relish 1/1/07 X X X YA DIE NMNO X 0 X DIE X Geoff Wilming 1/1/07 X X DIE YA X NMNO DIE X X DIE X Sara Baird 1/1/08 X DIE X YA X NMNO X X X X X David Shorr 1/1/06 X X DIE YA X NMNO X DIE DIE X DIE James McCue 1/1/06 X X X YA X NMNO DIE X X X X Billie Townsend 1/1/06 X X X YA X NMNO DIE X 0 X X Bev Witwer 1/1/08 X X X YA DIE NMNO DIE X X X X Scott King 1/1/08 X X X YA X NMNO X X X X X i I KEY: X = Present NMNQ - No meeting, no quorum o = Absent OlE = Absent/Excused 6 Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in-law, father- in- law, brother, sister, brother- in- law, sister- in-law, step-father, step-mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 3 Females: 5 Council Announcement Date: September 20, 2005; November 1, 2005 Application Deadline: Wednesday, 5:00 p.m., December 7,2005 Council Appointment Date: December 13. 2005 HUMAN RIGHTS COMMISSION One Vacancy - Three Year Term January 1, 2006 - January 1, 2009 Term expires for David Shorr Kate Colleen Karacay liS] 1522 Dickenson Ln Le Ann Tyson liS] 1408 Brookwood Dr Venus Hall liS] 2535 Bartelt Rd #1-B liS] Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION .-,\PPLlCA TION FORM I ~ I ~~~~1If: '-'" ......'- .....~ CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED .CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME Iowa City Human Rights Commission TERM 2006-2009 NAME Kate Colleen Karacay HOME ADDRESS 1522 Dickenson Lane ZIP ~NO~ )>~ :z: __; 0 -< -< Q - '" -10 .<. m 5:0 ;:;:^ P EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? 12 years WYes EMPLOYER N/A 2J r- m o "'CCUPA TION Graduate student and full-time mother PHONE NUMBER: HOME (319) 354-5174 BUSINESS -0 :JI:: ~ c:..> \.0 I am currently the treasurer of the UI School of Law's Iowa Campaign for Human Rights, an organization that has collaborated with the Human Rights Commission. I am also treasurer of the University of Iowa Amnesty International as well as the president and founder of the Iowa Human Trafficking Awareness Project, a group dedicated to legislation aimed at criminalizing human trafficking in Iowa as well as raise public awareness of the problem. I am also a part-time intern for the Iowa Network Against Human Trafficking as well as a part-time intern for the University of Iowa Center for Human Rights. As my involvement in local groups show, I am very committed to promoting human rights at a local level as I believe that is where the most effective work can be done as people have a more vested interest in their own local environment. Also, as a graduate student studying human rights policy and law at the University of Iowa, I hope that I can tie some of my research into practical applications by working with the Human Rights Commission. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? I know about the annual human rights breakfast, which honors local citizens, both adults and youth. As a member of ICHR, I am also aware of the Commission's Building Blocks for Employment. I also know that in addition to public outreach and event cosponsorship, the Commission works with the Human Rights Division to address complaints of discrimination, especially in housing and employment. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Human Rights Commission Application February 2005 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING) ? AS I mentioned, I have a strong interest in promoting human rights right here where I live. I am proud of the fact that Iowa City is a leader in the state and the nation for progressive human rights practices and I would love some more hands-on experience with that. Up until now, my involvement has been mainly at the university or state level so I am hoping that a position on the Iowa City Human Rights Commission will give me a chance to work with local officials and leaders as well as gain insight into current issues facing the community. I am also a believer in community involvement and outreach. I know the Commission does a good deal of work with this in the form of public education and community events in Iowa City, and I would love to get involved with this at a greater level. My work with the Iowa Network Against Human Trafficking, my own organization, The Iowa Human Trafficking Awareness Project and the UI Center for Human Rights has helped make me more outgoing and willing to reach out to media, public officials and the public regarding human rights issues and I would like to bring that enthusiasm to the Commission. I am also married to a Turkish citizen and have many ties to international students and scholars in Iowa City. I would love to seek out ways to get the international community more integrated and a part of Iowa City, if this is an issue the Commission would be willing to consider. POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies .' ''It apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. ~ ,her types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. n g None that I am aware of. ~ 0 ~ O~ ~ 11 -lC) .c<r m ""C -:JJ :li: ~^ ~ q;; ,.. I.D i m o [2]YES DNO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? WNO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Human Rights Commission Application February 2005 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING I! j ;:;;~-_IIt... :!:~~;!:"t. "'"-:. ....., ...... .. r CITY OF IOWA CITY Name of City Board/Commission Iowa City Human Rights Commission Name Kate Colleen Karacay Date 11/05/2005 Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). List all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS None = 0 = <:.n ~~ :z: . c::> ~ 0-< N ;::: ~r - ,-' ~ O~ :x llJ -- :f; .. W \D NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. I. ( .J,I c:.../: *' ~:,-.'. '-"" . . Signature Address 1522 Dickenson Lane Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Human Rights Commission Application February 2005 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 11, 2005 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size IPoverty Level) Income Income (low income I Income 1 $15,250 $25AOO $30,500 $40,600 $50,800 2 1 7 AOO 29,000 34,800 46AOO 58,000 3 19,600 32,650 39,200 52,200 65,300 4 21,800 36,300 43,600 58,000 72,600 5 23,500 39,200 47,000 62,650 78AOO 6 25,250 42,100 50,500 67,300 84,200 7 27,000 45,000 54,000 71,900 90,000 8 28,750 47,900 57,500 76,550 95,800 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments shall take into consideration men and women of various ,{SIcial, religious, cultural, social and economic groups in the city." lOrd. 94-3647, 11-8-94}) g ~() ~ -"'"=1 ~ 11 0-< N OPTIONAL: -to ! PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSI6i:A;w~ m CHOOSING AN APPLICANT. ~~ ~ 0 :;po; C;.) o Age Ilslam I Religi: Femalel Gender Inone Disability 53,0001 Income (see table) " Icaucasian Race, color or ethnic group heterosexuall Sexual Orientation IAmerican National origin D Other (Please explain below) Human Rights Commission Application February 2005 page 4 of 8 CITY OF IOWA CITY ADVISORY BOARD/COMMISSION r oPLlCA TION FORM FILED Individuals serving on Boards/Commissions play an important role i(!;Mvi~~~ Council on matters of interest to our community and its future. Applicants must reside in Iowa <H/tlvAfA CITY IOWA After a vacancy has been announced, the Council reviews aU applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED, .CONFlDENTlAl.. THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME JJ-t.l4l/1d..u r(l'y/dL (~'s;;t;.j'J/k... NAME A-vtV\ '5 (- HOME ADDRESS ' Dkw 1JvJ - I........... TERM I)i!cb- ,/J/O~ , I ZIP .s 2-:2J...fo DNo Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? 1+,-{'f(..(.5+ 2-d/:)2- O"CUPA TION ~(isv- - J~& c:A... c{f;;c:Jlry EMPLOYER PHONE NUMBER: HOME 8'+/- CJ {) 910 BUSINESS lf30 --I { 8"7 EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Yes -r ~~. ,~ ~ ~;(f ifpjr- t; +-~'u'-h~ --h:, y-t:- ~ fi-0-:;): ~ ~ Zh--oo.s-L. ---^~ ~ ?'- ~,'i . ,'_'~ J (-~ /1-._ tJ-S.s()(:A~?~JJ i?~J-~~ ~ f{,uS)1\fI-.. Di<..X<..- L r V'-"iCL- -r- 0 {' -"v'--n h~.J.... li'slJ4:--<,!.l<-.. /' .,} ~ ."A"'~. C~~. -L- <'-'L~ <'- C' / c~~ u.--. . '. ~.,-, ,) ~ ~('.,J2 ~.si.J~_Y fy0J. ~ ss I" ('~O- 0- ~ c.,- /'r1'-.. I) O. U [) , ...L /. rY'51..s;s,It~, }.Ja.i' 1 -=r:,D4:.~.s.N;A.A- <.- H,' '<- {\k~ 'Z..s~ ' - [J WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? 1\t'.S ,c.~'ssr't:-' L..O~/~~ .J2~~y\~v.\~ '-Y'~;qv ~6~ IIL-~C~.J......., y"-"- ~S~I~<::~_<S:? /L , b.. / ytcD~ ~ ~~ ~ ~.UiACU-<.- i/\-()lzi:J-1 , Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Human Rights Commission Application February 2005 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? I l~ ~(JI'O ~ S~t.I-"- ~~"---'-. 'J G<.,~'s.si~ <-~~. --k~ I ~~ ("~ ~ fY>^-<-'~, -M l"'WJ~ ~~ . ~'JI' ~ cl:uA.'$ /~ .V)9 co1V'ch'';:f ~/A. ~<'-<-<--. rt (~ " ~_tc~ , -::c- v:<;)~ " . () f C S (,f-. ""'--- Ct s.s:, 5TG "'<. G'L., I'" - t::u. Q,cL' ~ c ck.A- ~7J v-:- . , -L d- --"I ......1 ~ ~ 's,s ,'/AA.....; ("- ~'..f-, 0'.....-1 /4"-~ 1\.., ~'-"'j. J2_' ~ ~ uxuVt I~ C~~~ ~ u-'~~ 1:> rTh~tJ. ~ 4~~ ;~ o~ ~'~, POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. MAffiliation" includes being a board member or employee of the agency. .1er types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). If you are uncertain whether a potential conflict of interest exists Or have questions about Section 362.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. JJL~ ...., = = CJ> <::> f"1 ('") I 11 - I m o o ~Q C)::I ::Jc;. --< r' n-l O:JJ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? YES DNO ):> DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES J:>o :x - ~ (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Human Rights Commission Application February 2005 Page 2 of 8 BOARD, COMMISSION, & COMMITTEES BUSINESS LISTING I! 1 !~~~'t -.;;;::.... .....~ ~- CITY OF IOWA CITY Name Name of City ~ Board/Commission . dA.A.- ~ ~"" ~<; ,r0 Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). ~fkt-~ ~'S5/~ /, if Date II/d-R/lr List all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdingsl. Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS J I\ltNL . -. <5 = = eon . ~O !:2 h -::; ~ - 0-<' I .~ - 2r--' p . -r.:;::, ,.,. O~ ::;; ~ .. - NOTE: A new form must be completed if the above information changes or an ownership interest is acquir in an additional business. , Signature Address Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Human Rights Commission Application February 2005 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 11, 2005 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size IPoverty Level) Income Income (low income) Income 1 $15,250 $25AOO $30,500 $40,600 $50,800 2 1 7 AOO 29,000 34,800 46 AOO 58,000 3 19,600 32,650 39,200 52,200 65,300 4 21,800 36,300 43,600 58,000 72,600 5 23,500 39,200 47,000 62,650 78AOO 6 25,250 42,100 50,500 67,300 84,200 7 27,000 45,000 54,000 71,900 90,000 8 28.750 47,900 57,500 76,550 95,800 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore, "appointments shall take into consideration men and women of various racial, religious, cultural, social and economic groups in the city." lOrd. 94-3647, 11-8-94) OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. DAge I Religion I Gender I Disability I Income (see table) I Race, color or ethnic group I Sexual Orientation page 4 of 8 o ~o =< ~~ <;;:'^ $; I National origin N = = en = I"TI " I 11 ~I o Other (Please explain below) Human Rights Commission Application February 2005 :::- ::B: <;? c..:I CITY OF IOWA CITY ADVISORY BOARD/COMMISSION \PPLlCA TION FORM I ~ I -~= -10 ~~~;!:tt -..;::.... "'11II''- ..,. ....... CiTY OF IOWA CiTY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED .CONFIDENTIAL,. THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME 7 hP. .f..I1J1VI(/JI/ Rig frfs ~/Ss/otERM I7I-tN-~ -4/-(Y-tJ'l NAME mg. Ve()IJ.5 'Renee.. tktU HOME ADDRESS ~53S Bt1rfe./-I- Ro~cI-#I-t3 ~ 5.;7!Y~ Is your home address (listed above) within the corporate limits of Iowa City? ~Yes ~o ~ ~ ~ n ~ How long have you been a resident of Iowa City? p( yet:lr$ () I r=i ~. -.l r OCCUPATION amtriCfh<;J~ I/u IUrrle~,e. EMPLOYER ,oh~o .n:;11~d~ m '-lONE NUMBER: HOME .$/'1- 3S'l-/~8'O BUSINESS el7m;?Jtll1l~~I7~~ 0 )> EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: .:r ai"f7 (;In ,'r-9>? ~"/(,4J?1 tJl2i1'n h/4 -e # ~ .' 1/117 <II ~,y /nsen-HY e/1tUllul 4-1 'hv ~:;~n1jZ~Y~;:. :~4 C'bml""/,-4o--v ;n,?"~' .::r /14.tK ~;"',k....;, ~/4;r~/I'/i /?V~/.,<= ~I' :Jt,H //v Chl"'~d ..7//. :I ~h1 J:; p'" ~:;~ ~~..t: &.nn?-'I'q St:~;U.NG.<'. ..:z: HI?? ~...h, c;~~m::" ,,_ _ . '/ ~,.4::r -e4y. SL /Y.. ~- - .:z:- AI;..., "C~1r.;I,~u '" -rq'/J ""/~;;.t <~ /. r:>>Je... b/'li!.. <..J>'r7~. "- _ -/J.., ~.,~.~ ~~ A!,....( ~~Cq/ a ~p'"J4 / /-'1~y".rJ- /n ,. "/ .:;r;~4()'J J'u.dA-~ 1,4./1' /~ /4&/'IP flit'''' ,i/()'x.J' , WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? r)EJ<y' t/Ittt. ~'" 'w;/J>,'f /lttt.&J' -h'n-;.tR //'7 ~,~ ~ J'd4/ -/7> ~ 4-" ~ i/21t'.e// .;;b ~ ~"'P7H?//r...~ -.l Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Human Rights Commission Application February 2005 Page 1 of 8 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? .::r h~ tI./P1ebd' U'/71f >>tP--Y-Y d~~ CU//br~ t:2J U/e/' 4J'p? c/;lIu~nI- //JtCJ>>d I~. ~r l/kJ'~/e tf.! 4~ A.fr,et?r;? t?rnRr/CP?? --eN # htJ.f /l"tk~/ ~ .6;""7"/ /C~OJ;f:<. -/ u /n ~~",a/ :T'J;e ~ -/ole/ ~ ~ fCYJlP"l/"'T~ d ~ / -h ..4:-c7' In/' /l2o/.eIf"/ ~I .::T ~ tleA<tt Arhwa t2 A4tt? .J'. f' '" . L" / . /~ (?dH?--."r-.rJ,,;C:).-..J ~ .:r evtJv/c/ fl-'Tp h. C; ;l~17V 1f!C~-r -r; ~ T~ $0 ~ =z:./ POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. "'ther types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~o )>:::::j 0-< :::::j0 ':<\-n -:0 27' )> 11 - \ m o "" :x &" I X IYES DNO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? 0 YES -J 5(] NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Human Rights Commission Application February 2005 Page 2 of 8 BOARD. COMMISSION. & COMMITTEES BUSINESS LISTING I ~ ! ;i:~;';'~tt ~... "III" ~....... CITY OF IOWA CITY Name of City Board/Commission tHE HltIhOIJ.. !?'9hfs COl7?m; SS"a\/ Name f'l1g. VetlU!5 R~. 14a LL Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 7). Date /J- 0'- OS" List all businesses in which you or your spouse/domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS Nf)Nt:; n = = :if20 ::;:: (1--< < > - ~ I -jf2 .... r ~ . ;=:;:0 ::i \ ;;E' .s:- . -I . NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Signature 17fo. / f/1U6d If-~ Address ,;(635 2S4,-felf ~a/ tI6 /-,8 ..IOt.u::~l!f rA S~<I".6 Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. Human Rights Commission Application February 2005 Page 3 of 8 TABLE OF INCOME GUIDELINES AND DEFINITIONS FOR IOWA CITY Effective February 11. 2005 Household 30% Median Income 50% Median 60% Median 80% Median Income Median Size (Poverty Levell Income Income (low incomel Income 1 $15.250 $25.400 $30.500 $40.600 $50.800 2 17.400 29.000 34.800 46.400 58.000 3 19.600 32,650 39,200 52,200 65,300 4 21,800 36,300 43,600 58,000 72,600 5 23,500 39,200 47.000 62,650 78.400 6 25.250 42,100 50,500 67,300 84,200 7 27.000 45.000 54,000 71,900 90,000 8 28,750 47.900 57,500 76,550 95,800 ATTACHMENT TO APPLICATION FOR THE HUMAN RIGHTS COMMISSION It is the mission of the Iowa City Human Rights Commission to protect residents of the city from discrimination as defined in the Human Rights Ordinance. In order to further this goal, the city strives to ensure that the Human Rights Commission is representative of the community. Therefore. "appointments shall take into consideration men and women of various racial. religious. cultural, social and economic groups in the city. . lOrd. 94-3647, 11-8-94) OPTIONAL: PLEASE PROVIDE ADDITIONAL INFORMATION FOR THE COUNCIL TO CONSIDER WHEN CHOOSING AN APPLICANT. 1~IAge BAal,. s -f . I Religion FEmALe I Gender I O&sI7Y /19Jl7H?'fl'S I Disability 30 10 IY1td i Q Y) I Income (see table) . I Race, color Ilmt-firtlN or ethnic group I National origin ~uo>e~\.(({ 0 Sexual Orientation II1k iClfm I D Other (Please explain below) uman Rights Commission Application February 2005 page 4 of 8 ...., ~~ = = en <::I ,.. ~ C""'> I -.J -0 'm 0 ;=:;:D :x ~^ .r:- )> -.J 1).-13 05 /q :3 NOTICE THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING COMMISSION: PARKS AND RECREATION COMMISSION One Vacancy - Unexpired Term Ending January 1, 2007 The duties of the members of the Parks and Recreation Commission are to recommend and review policies, rules, regulations, ordinances, and budgets relating to parks, playgrounds, recreation centers, and cultural functions of the City and make such reports to the City Council as the Commission deems in the public interest; to exercise broad responsibility for the development of parks, recreation centers, playgrounds, and cultural facilities to serve the City--including the creation and appointment of advisory groups to make studies. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Parks and Recreation Commission meets the second Wednesday of each month at 5:00 p.m. Applications must be received by 5:00 p.m., Wednesday, December 7, 2005. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Parks and Recreation Commission should be directed to Terry Trueblood, Parks & Recreation Director at 356-5110. RilIkS and Recreation Commission November 9, 2005 Page 6 of 6 PARKS AND RECREATION COMMISSION ATTENDANCE RECORD YEAR 2005 TERM NAME EXPIRES 1/12 2/16 3/9 4/13 5/11 6/8 7/13 8/25 9/14 10112 11119 12/14 Craig Gustaveson 1/1/07 NM X X X X X X X X X Judith Klink 1/1/07 NM X X X X OlE X X X X Margaret Loomer 1/1/08 NM X X X X X X X X X Ryan O'LearY 1/1/06 NM X X OlE X OlE X OlE OlE X Matt Pacha 1/1/05 NM X X OlE X OlE X X X X Jerry Raaz 1/1/08 -- --- X X X X X X X X Phil Reisetter 1/1/09 NM X X OlE X X X OlE X X Sarah Walz 1/1/07 NM X X X X X OlE X X -- John Westefeld 111/06 NM X X X X X X X X X KEY: X= 0= O/E= NM= LQ= Present Absent Absent/Excused No meeting No meeting due to lack of quorum Not a Member Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in- law, father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 6 Females: 2 Council Announcement Date: November 1, 2005 Application Deadline: Wednesday, 5:00 p.m., December 7, 2005 Council Appointment Date: December 13, 2005 PARKS AND RECREATION COMMISSION One Vacancy - Unexpired Term Ending January 1, 2007 Sarah Walz resigned John Watson [8] 1105 Barrington Rd [8] Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPlICA liON FORM I ~ I -.... = -~... ~~w.~~ ~... ....''- ....,..~ CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BE . CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME)JO"....1l.. _~ \t..c.:V...D.."t......:. NAME .) o\"~ f\. t01o(ii:.t.'::' . HOMEADDRESS\lo~ 1>...\""~~'"1-........ K~ Is your home address (listed above) within the corporate limits of Iowa City? "0 Yes Cj Ly....... TERM ZIP S~4-" DNo....., - = o ~ ~O g O~ -< 11 =lO CD .o-<r:;:; -0 -::0 :JI: EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~ ^ ~ - - Lv { ~ '-'I... .Q t~..Q ~ D...e~ ^^ ". _ n n n 1_' \) , ~.eC . \ '\~c:..H"," I ~ \. ..."<....~ .....,..... ~"-Ll ~ ~...... ~ ~~ ~- ~h\o:c.-'1-..p"t "" 'i \ t.:... e.....~\. e4 "a. \:-\.."" ~ "U ~ Cl.. cQ'\c4 '":J '" 4~ "'1 .... he L...~ o.._n ..... C) \~ ~ ,.... ""(""'--.....~........ \..... :to ~ . L" <:~.c.'l/..Q. L.' L.C t:e... . 10_' t) 'r~. How long have you been a resident of Iowa City? JCCUPATION ~'\vl.Q PHONE NUMBER: HOME ~\'\-\~Y-(.S"YO EMPLOYER - BUSINESS ---- , m o WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ~ CAA- ~-. 1, ~-{J- Y(C._"\-':'" a... q ~~ b~lI~ "'0 ry-o.J. ~iq'lA... \'- Q:c"",~,,\...:-. C<<..,,, L j J...c...o.... ~"'~ l.u I t( ~ 1t.. ~ -u.....~'- bI.... w ~_ \l.>.Q Q -0"'-'/1...... Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application February 2005 Page 1 of 7 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR o.PPL YING)? 11 A.Jl ~...,"CV\~: e-.~\J( u. '^"-~~ G~ ~O~ \s'-- ::u l.\.~",-'( ~ '^-L. ..J( "-r l....u... Q ~ '\ Il "'" .IL.v;.. ......, ~ L.;.\t c.-O~ ~~ yw.Q.()-o.... ~ ~ cy...J.. L~ 't (l.( r j .-!l....~ \ 1)~'l ~ ~~'" ~~ VtJ\'<.. ~'i)..... . .) ...... -<\\.'-4t.i\. '- ~ ~ I &..;t'f ~.~ 'i---)~ ~ ~~~1~~ let ~..,1.~ - ~~ LJ.J..f ~ , .... 't-~ \" lL.:.., Q . -\) POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests. including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies :hat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). 0) -0 :J:: ~ 11 r m u ". IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? BYES DNO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES 'EJ NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application February 2005 Page 2 of 7 BOARD. COMMISSION. & COMMITTEES BUSINESS LISTING I! 1 -~= _.~ !~W~'t "--~..~.~ --.: :..... CITY OF IOWA CITY Name of City \) ~--L Board/Commission ''4'0\.''- '" V..t..k,.,\' l~ Name ~ .\ \,-,\ f1. WoW ~ <l~ Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). Date l e,,-l\ -0 \'"" List all businesses in which you or your spouse/domestic partner have an ownership interest (for example. sole proprietor, partner. 5% or more of corporation's stockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS \ . '\ \ , \ \ '\ \ \ '" \ \ "\ "\ \ '" / , ....., , = / "" ~O C> I /~-:J. -t .J: /~O co ( - ,Q:l -0 ..; :x ~" ~ .J> C> NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Signature <=1-l. G lJ..-{...,....... Address Hoc- ~ (kyy~""-t..... K.{> , Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application February 2005 Page 3 of 7 12-1.3' <'s- /9 A NOTICE THE CITY COUNCil OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOllOWING COMMITTEE: PUBLIC ART ADVISORY COMMITTEE Two Vacancies - Three Year Terms January 1, 2006 - January 1, 2009 Duties of the Public Art Advisory Committee include developing by-laws and procedures for the Iowa City Public Art Program; administering the Public Art Program by determining the placement of public art, the type of art to be used in a specific project, and the artist to be engaged; overseeing the acceptance of gifts of art; overseeing the maintenance and disposition of public art; and overseeing expenditures of the Public Art Program budget. Iowa City appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Public Art Advisory Committee meets the first Thursday of each month at 3:30 p.m. Applications must be received by 5:00 p.m., Wednesday, December 7, 2005. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Public Art Advisory Committee should be directed to Karin Franklin, Planning & Community Development Director at 356-5232. RlIblhj Aft Advisory Committee Attendance Record 2005 Term I , , Name Expires 1/06 2/02 3/02 4/07 5/05 7/07 9/01 10/06 11/03 12/01 0/00 I Emily Carter Walsh 01/01/08 CW X 0 X X X OlE X X I I Charles Fellin2 01/01/06 CW X X X OlE X X X X I James Hemsley 01/01/06 CW OlE X X X X OlE X X , I , Emily Martin 01/01/08 CW X OlE OlE X OlE X X X I Mark Seabold 01/01/07 CW X X X X X X X X I Rick Fosse CW OlE X X X X X X X Terry Trueblood CW OlE X X X X X X X I I i i Key: I X = Present 0 = Absent OlE = Absent/Excused NM = No Meeting CW = Cancelled due to Weather I I I Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in-law, father- in-law, brother, sister, brother- in-law, sister- in-law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 1 Females: 2 Council Announcement Date: September 20, 2005; November 1, 2005 Application Deadline: Wednesday, 5:00 p.m., December 7,2005 Council Appointment Date: December 13, 2005 PUBLIC ART ADVISORY COMMITTEE Two Vacancies - Three Year Terms January 1, 2006. January 1, 2009 Term expires for Charles Felling, James Hemsley Charles Felling [ID (Currently serving 15t 3-yr term) 825 South 7th Ave DaLayne Williamson [ID 830 Ronalds St [ID Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM I! I -,....= .~... .~~.III~."~~ ::.. . _"'~ ..........I.L il CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council On matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen). typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED 'CONFIDENTIAL." THIS APPLICATION WILL BE CONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. qARD/C/OMMIS~1 N ~ J:?(t-< ~ /::. ~+ f?d(.J/S~'ry{2,h1.",<.TERM jJ~ I;~:; NAME 11 0 I-- e5 I\', 't e tt VI. ~ J ? HOME ADDRESS 2]:J 5 g Ol.l-~ f) - -e VLu'e ZIP ,-)d:Jt.{ 0 Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes D No '13 lj ea..r5 , How long have you bren a resident of Iowa City? ')CCUPATION 1?~ t,'re..d . EMPLOYER PHONE NUMBER: HOME 3 J C) 3'3 '6 (, 99 If BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Wl.-y I <l!- ~ j es t ~c1 .s ".. ~ . lOVl.'a<P I h:l . I ee '" '. ~ 6.nvll!..tJ.., a.....-h;-rQ~~"J +<-<--0 d;......L~..~ <>-rif- (f<..u.-l:-- ~ ~7"Q(jt,;f~' 0<.. te.a-cL,'",-'] h~<e. ;"" d~t/~""/-K,<LV"tlC.e5!> o.-J ~1d"~ +....u, /J .jL Ot.v-'t ..". -/; I...- ~ Q .-.r7 "<2}~~.r J' <{ Y e..t- S <1> 'cP . ~~(!-m --:->/)1"(<:''1 L.U:-K.,.';.,-t-"-~:v-,,- a. "1 f?,..", R"d";$t>r'7 ~...;I'th~.... ~~i l c1.e.e. S I f' "'~(fb;..JS , ~d ~.") 0.... -to , +.s I ~ ",~ --1-4 d<w~~ f:; m ?wt. I. a. C1t..l-~ ~ (k"... '6-..w......... '"--93 ~ 0 ~~ ~ WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? -:;:: h4v'e- S evV'-e.J ":' ~ ~ (~~ f'47o,) ~ .,.,..,/ e<+ !.....;", "(!1/6.J.......:t- Tt> ~ (-ell.. <<. + ~ ./2-. u- a..,.. 1>>-: H...... ............. I...... ~ W. t-e, , ,.,.......!. Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application February 2005 Page 1 of 7 WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? -::z: be-he.-.. ~ T: ~ <L b oet.,v a.-" Ie ..fa m.&. ILe4 ~ I; f t -14 vU M<..';; ftu... p"", (. ~ }:7,.. + (l de" i "'" 7 C14-w.1 U~., e.5r(~4 ~""-'?""'n. l?Jy ,~~ ,rfJ. ~(j~"~~ .....'.Hvol-rJ ~ n~.j-M~ t7". .1Jj,L, a..f w<ii!. O<?v-h......~ +1.-.. f""~7~ 'd~- "'N $0 (!.4 I . p .f. a..JJ ru h ...., '1 a... $......, e ".{J,. ""-'l'i.., of.., kJ' -tJ.. 'C. ~-ev~ . li"" ~ L_: "-'- h. ;. "'- "'- a t--~IV -eo v..> ') . c.AA.. -\ '" ~ Y\. Q./I 0-." .... .--- q--' __v- J - .. .. \tl. . b p- :.Jrd:.p~ +t...-. & .ct.-.........,.:., >-O-ij"'....... ~J-e 0 ,- . ~ ':: i-k~....:ih ~ d~ 6.q "'~f I ~--1 ~.J.e., POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. In particular, if you are applying to be a member of a board or commission which makes recommendations to the City Council about the allocation of City funds, please list any present affiliations you have with agencies that apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other tvpes of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section ~2.5 of the Code of Iowa, please contact the City Attorney's office at 356-5030. <5 ~ . :x;~J g -I ..... 0-< N - () ... ;::!, m -::lJ ~^ )> 11 r m o -0 :x ~ ... IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? I xlYES DNO DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYES 1'">< 1 NO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application February 2005 Page 2 of 7 BOARD, COMMISSION, & COMMITTEES. BUSINESS LISTING I! 1 :e:~.~_A.... !:~W;!:"!. -..;;..... ......~ ......~ . CITY OF IOWA CITY Name of City h A n,t? . Board/c~c:;n H- '; \rl ClII " 6 A,. r t..: ~ 1m i +4- 'tJo(. Name Ie" I? (j:"..eJI('M~ Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). , Date tJaf. :; t ~-- List all businesses in which you or your spouse{domestic partner have an ownership interest (for example, sole proprietor, partner, 5% or more of corporatiori'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS ,AI" J1.-.p ~ = 2,", "'" r-> )>:::1 n - t! -I q" '~ ! r- .... :<hi ~ ~ g~ ~ - 5> ":. . NOTE: - Signature Address ~ e.'i Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application February 2005 Page 3 of 7 Page 1 of 1 Marian Karr From: mcfelling [mcfelling@mcleodusa.net] Sent: Monday, October 24, 2005 7:49 PM To: council@iowa-city.org Subject: Request for appointment to Public Art Advisory Committee I have had the opportunity to speak with each of you on past occasions as I worked with the Neighborhood Council and during my current tenure on the Public Arts Advisory Committee. The time you spend on city matters is considerable and I will not needlessly take up your time. However if you feei that you should talk with me as you consider my appointment to the Public Arts Advisory Committee please respond to this e- mail and I will contact you at a time convenient to your schedule. Sincerely, Chuck Felling 319-338-6994 10/25/2005 - -~~---,-----~._--,--~-~--_._---_._~--------_._-- ".._---------"-_.._-----~~- CITY OF IOWA CITY ADVISORY BOARD/COMMISSION . .PPLlCATION FORM I! I -....= -~ !~W;!l:8lt ~...... J!MI!'!!.''- ..,.. .. CiTY OF IOWA CiTY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION WILL BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICALLY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ADVISORY BOARD/COMMISSION NAME \)\A\:7\i (, A-rt.. ~Vlse,.Y'l1--CO(YIm:rERM: 3 ~~ Youth Advisory Commission, Age on the date offiling:D Age 15 to 17 (or) D Age 18 to 21 Signature of parent/guardian if Age 15 to 17: . ..ME '\)C\L.-tM-j~ \".il\\i cnV\SoV\ HOME ADDRESS 9 30 Rowu It ~ S. 1-: IG ZIP [I] Yes 6d-d-4-5 DNo Is your home address (listed above) within the corporate limits of Iowa City? How long have you been a resident of Iowa City? ~O ~ OCCUPATION ~( Rte-z.tu'-t:ty EMPLOYER Mev-U"h ~lY\CU'\ ~Yc.t~ PHONE NUMBER: HOME :33l- L(-6qh BUSINESS 8gl- '/Q3;}... (.DV\~~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: \ Wcx.S ~ ~D\'(\t of- CD\f\'tacC. feY --\V\L NoY\t1~d.L N-fA'?J;\\poYY\DOd. kr-t'\ "': ~ N'd~\0b6YV\~ pVD)cl OJN).. VVAV1L (\ S~YOY\l!) \Y\{eX'-{~t iY\ t>\AP\'Co~' ~o g :;! " .,.., C) ,~ " o-J I II Misrepresentations on this application will constitute just cause for removal of an @)lI~int~. If ~ fail to answer all the questions, Council may not consider your application. ~ ~ II - W General Application November 2005 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? \ "'{-..rAVe, \rJuy\ C\ ~($t (}j:: {).. VYUt\-i~~ rwY'~Y1-tIlf\q . W- NtJf\:'. \ lM'\tltAs~ ~ M5WSS. tU/\c( YekD\'VIVYltM. i . -+0 ~ COLAY\cAl. . WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? J: \AAV~ \\VfJ. iYl ~DWl'l U-b-j fDy vy\(A~ ~/t1\S ~S C\ <;'-tM~V\..t aV\A l\ ~ o/\k. \ ()vVV',. v...ri \ \ i V\lj +0 \ \ <S:.tlv\ O\0'I~(-:\'\ ~ ttVl ~ ~ \~\PV\S-\-V lA cD v( -k~d !Dark . \ OJ/V\ \ \(\-11 v -eS1x M " V\ y\t\l^~{ V\t?J . \ OWCt.. ci ~ 0... \Gettttti fu{ \V\-ttve~Y\Oj ~\~~t -to \\~ CAm V{81+ -~'''W''OIA~ fJ\'\COVy~q;fl'! ((V-\D\i c.. Ctr-r-,' . POTENTIAL CONFLICTS OF INTEREST Please identify any potential conflicts between membership on the advisory board and your personal interests, including financial interests and your duties to an employer. ... particular, if you are applying to be a member of a board or commission which makes recommendations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. You should also know that Section 362.5 ofthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [5Q Yes D No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYes lXJ No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) = Misrepresentations on this application will constitute just cause for removal of an a~eedi you fail to answer all the questions, Council may not consider your application. C) :;:! ~ 11 --.., J _ rn rn O;;Q ~ 0' I I -<;;:-^ ~ ~ W <.0 Page 2 of 7 General Application November 2005 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING I ~ I ~~~~'t -.;:;:... "'IIIII~ ..,..~ CITY OF IOWA CITY Name of City Board/Commission \>\AIo\i c- I\rf-, ~V~'SDY0 U)'r'\1Yl'1. Date ~ Name '\) CZ l4W W \ \ \ \ (A vy\ St5 VI Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or.parent if applicant is Age 15 to 17, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. BUSINESS NAME BUSINESS ADDRESS NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an additional business. . Applicant Signature ~~ {)Jr1.1.A..ti~ Signature of parent/guardian if Age 15 to 17: Address <l30 tZoV\tUc{5; sr. Ie. I Pr 5~ o ~.~ ,..., = ;;;; = YI'll ("') Misrepresentations on this application will constitute just cause for removal of an ~~inte"tt. If ffl fail to answer all the questions, Council may not consider your application. 6 g] ~ b 5> w General Application '" November 2005 Page 3 of 7 I /~-13 ,oS-1 1/ NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: SENIOR CENTER COMMISSION One Vacancy - Three Year Term January 1, 2006 - December 31, 2008 The duties of members of the Senior Center Commission are to: 1. Serve in an advisory role to the City Council with regard to needs of the Senior Center. 2. Make recommendations with regard to policies and programs at the Senior Center. 3. Join staff and other interested persons in seeking adequate financial resources for operation of the Senior Center. 4. Encourage full participation by senior citizens in the programs of the Senior Center. 5. Ensure that the Senior Center is effectively integrated into the community and cooperates with organizations with common goals in meeting the needs of senior citizens. 6. Serves in an advocacy role with regard to the needs of senior citizens in Iowa City. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Senior Center Commission meets the third Tuesday of each month at 3:00 p.m. Applications must be received by 5:00 p.m., Wednesday, December 7, 2005. The City of Iowa City encourages diversity in the appointment of citizens to boards and commissions. Persons interested in being considered should contact the City Cierk at City Hall, 410 E. Washington Street. Application forms are available from the Clerk's office upon request or on the City website at www.icgov.org. Questions about the Iowa City Senior Center Commission should be directed to Linda Kopping, Senior Center Coordinator at 356-5225. DRAFT NOVEMBER 2005 Seriiar CaritaI' Commission Attendance Record Year 2005 Name Term 1/24 2/15 3/15 4/26 5/18 6/21 7/19 8/16/ 9/27 10/18 11/22 Exoires Lori Benz 12/31/05 OlE X OlE X X X X OlE X X X Jo Hensch 12/31/06 X X X X X X OlE X X X X Jay Hanahan 12/31/07 X X X X X X X X X OlE X Betty Kelly 12/31107 X OlE OlE X X X OlE X OlE OlE OlE Sarah Maier 12/31/06 X X X X X X X X X X X Charity Rowley 12/31/05 X X X X X X X X X X X Nancy Wombacher 12/31/06 X OlE X X X X OlE OlE X X X Key: x= 0= O/E= NM = Present Absent Absent/Excused No meeting Not a member 4 Spouses and relatives of City Council Members and members of comparable County Boards and Commissions are not eligible for appointment to City Boards and Commissions. This includes: spouse, child, mother, father, mother- in-law, father- in-law, brother, sister, brother- in-law, sister- in- law, step-father, step- mother, step-child, aunt, or uncle. (Resolution 85-354) Males: 2 Females: 4 Council Announcement Date: September 20, 2005; November 1, 2005 Application Deadline: Wednesday, 5:00 p.m., December 7, 2005 Council Appointment Date: December 13, 2005 SENIOR CENTER COMMISSION One vacancy - Three Year Term January 1, 2006 - December 31, 2008 Term expires for Lori Benz Robert Engel l&l 725 Bradley St l&l Denotes applicant completed the Confidential page of the application. CITY OF IOWA CITY ADVISORY BOARD/COMMISSION APPLICATION FORM I! ! -"'= -~... !~W!:'"'-~ ~... .....t'- ....... .. ""'\J CITY OF IOWA CITY Individuals serving on Boards/Commissions play an important role in advising the Council on matters of interest to our community and its future. Applicants must reside in Iowa City. After a vacancy has been announced, the Council reviews all applications during the work session. The appointment is made at the next formal Council meeting. Appointees serve as unpaid volunteers. This form may be filled out manually (please use a black ink pen), typewritten, or electronically (PDF). Return the application to City Clerk, 410 E. Washington St., Iowa City, Iowa. THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLIC, WITH THE EXCEPTION OF THE LAST PAGE MARKED "CONFIDENTIAL." THIS APPLICATION Will BECONSIDERED FOR THREE MONTHS ONLY AND AUTOMATICAllY CONSIDERED FOR ANY VACANCY DURING THAT TIME. ..... t :ll\lJI, ~c2,\ ADVISORY BOARD/COMMISSION NAME '- )0.,\"..- ~uAc.. ~'<<\.t<"\\bMOj.J TERM:.:woC. 40 :AI::D?I Youth Advisory Commission, Age on the date offiling:DAge 15 to 17 (or) 0 Age 1lDo 21 b - "'" o oJ' 1iq 8 -II lAME f'<t9he-r- r E f?ht;"eJ '?,',3D &, ~. iJ ~fTl ~ 0 HOME ADDRESS 720- J),aciley S1'J Li..J'^-C~l!, :sit- ZI~~~t.{O Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes J>D No- How long have you be;:) a reSident of Iowa City? S " Yl c- e. ,-T LA. Y\ e I q ::,-g OCCUPATION Ii e. t,' red. EMPLOYER Lt, 0 + r PHONE NUMBER: HOME 33??- '-f()Cj.fl BUSINESS EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: Signature of parent/guardian if Age 15 to 17: vttQ~ 01 w~ C:;;6:; / j);I, V-~,,-CI",-,~ A, .~ ~/~ / 'i'ij!. #kx~~~~~~~~.~/}o) ./-2-~ f:.-? : ~ c.r--t.&~ m, ~~..s- {5- 'I~J; ~~ &. j /J-07fi~ ~ 'i cF~ t (~W>~ (I 'i 7'4); ~ e;;-(4 f?~--I;v. P 4,;.,,/?_.(!:,-~; /f~~ /~L2-f; ~.~ t2...('t 7~U. Vh. ~~; ,~~t~~ J--U41::/FJM'-/r;91_ , Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application November 2005 Page 1 of 7 WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? !7h~~ J :^-~""~~y4 ~~~" J h..u-e- o-ko~t_(" CclhA/O'v.z...<-4<,>1,. 4~ (f"T}~J CA/~~ '1 ~- c..,...~~~-if~' ~ = 6 ~ ~o\ ~ 11 01..- ~o C1' \-n C<I I", Please identify any potential conflicts between membership on the advisory boar1L~ ~r ~onal interests, including financial interests and your duties to an employer. ~7: 9 -- ~ .1 particular, if you are applying to be a member of a board or commission which makes re?cimmemtations tothe City Council about the allocation of City funds, please list any present affiliations you have with agenciesthat apply for funding from the City. "Affiliation" includes being a board member or employee of the agency. Other types of affiliations must be examined on a case by case basis by the City Attorney's office. WHAT CONTRIBUTIONS DO YOU FEEL YOU CAN MAKE TO THIS ADVISORY BOARD (OR STATE REASON FOR APPLYING)? )--- ~ J c~~ dAd~ c/^- nu ~.~ t;:;.~ ~ ~ <7~ h^""';:T:&flV~ Cifl';;.(~_ U<A'4;z;. . ~/W. _~i2~/,~ ~~ C7~ c- ~ Y-~;:1~ o-.?~~~~~V- ~ J --- , .. J -/~ ./J.-.t,>..."..rc_-e~~r:'~ z;i;' ~-1 ~TY-bv~. POTENTIAL CONFLICTS OF INTEREST You should also know that Section 362.50fthe Code of Iowa generally prohibits, with certain importantexceptions, a member of a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached (see page 6). If you are uncertain whether a potential conflict of interest exists or have questions about Section 362.5 of theCode of Iowa, please contact the City Attorney's office at 356-5030. ~rw{' ~ q~C4~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? lKl Yes D No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? DYes J2jNO (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application November 2005 Page 2 of? BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING I ~ I -.... = -~... f~~-ai~"y. ~.. ~=I' ..,..~ CiTY OF IOWA CiTY Name of City C'. /, + /Ii I, Board/Commission (::) <e 01' c.l r L e Y1. e> r" LLJ Vh-I'k f .;:;[Jd't Date Name Rober r Eo EVlJ e I . /')e c- ~ ZO::JS- , Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a memberof a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 isattached (see page 6). List all businesses in which you or your spouse/domestic partner, or parent if applicant is Age 15 to 17, have an ownership interest (for example, sole pr~p~etor, partner, 5% or more of corporation'sstockholdings). Please indicate if there are none. N 0 It! E BUSINESS NAME .' . BUSINESS ADDRESS . ......' = 9_ ;=, J;:::\ ~ 11 "'- ~ r- . o. ~'r-' ...... \..!-\ ;=;':rJ ~ '--' -S;/ ., "'- -'" - . NOTE: A new form must be completed if the above information changes or an ownership interestis acquired in an addMsiness. . _ Applicant Signature ~::;;- ~~ Signature of parenllgu~rdian if Age 15 to 17: Address Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail to answer all the questions, Council may not consider your application. General Application November 2005 Page 30f7 Page 1 of 1 Marian Karr From: Robert & Elizabeth Engel [reengel@avalon.net] Sent: Monday, December 05, 2005 2:30 PM To: council@iowacity.org Subject: Senior Center Commission To: Iowa City Council From: Bob Engel I will turn in my application on Tuesday, December 6, for a 3-year position on the Senior Center Commission. If anyone has questions for me I will be glad to answer them. I can be reached at 338-4098 or bye-mail at reenaeltCilavalon.net 12/5/2005 Kellie Tuttle rnn From: Sent: To: Tracy Hightshoe Thursday, November 17, 2005 12:45 PM Kellie Tuttle Cc: Jerry Anthony Uerry-anthony@uiowa.edu) Subject: FW: resignation HCDC resignation. We will need to post a vacancy. From: RMarcus847@aol.com [mailto:RMarcus847@aol.com] Sent: Thursday, November 17, 2005 11:47 AM To: Tracy-Hightshoe@iowa-city.org Subject: resignation Dear Tracy Please consider this e-mail as a formal resignation from the Housing and Community Development Commission. I recognize the value and importance of this commission and simply can't afford the time necessary to do an appropriate job for the City of Iowa City. I deeply regret this decision from a personal standpoint, but it is the right thing to do for the Commission. Thank you Rita Marcus Rita T. Marcus, Licensed Realtor in the State of Iowa Blank & McCune, The Real Estate Co. 319-354-9440...office 800-451-9440...toll free 319-354-4550...fax 319-594-5600...cellular 319-351-0809...home 11/17/2005