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HomeMy WebLinkAbout2011-03-22 Appointment14a NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy -Unexpired + 5-yr Term Effective Upon Appointment, ending December 31, 2011 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, March 16, 2011. 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 Michael Tharp, Airport Operations Specialist at 356-5045. 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: 1 Council Announcement Date: June 13, 2006; August 1, 2006; September 5, 2006; September 19, 2006; November 14, 2006; December 12, 2006; January 9, 2007; February 20, 2007; March 20, 2007; May 1, 2007; June 5, 2007; July 24, 2007; September 18, 2007; November 5, 2007; December 11, 2007; January 29, 2008; March 11, 2008; April 14, 2008; May 13, 2008; June 17, 2008; July 15, 2008; August 26, 2008; October 6, 2008; November 18, 2008; January 6, 2009; February 24, 2009; March 24, 2009; May 19, 2009; June 16, 2009; July 28, 2009; September 15, 2009; October 20, 2009; December 1, 2009; January 25, 2010; March 2, 2010; April 6, 2010; May 10, 2010; June 15, 2010; August 17, 2010 (Gender Balance in Effect); September 21, 2010; November 16, 2010; December 7, 2010; January 10, 2011; February 15, 2011 Application Deadline: Wednesday, 5:OOp.m., March 16, 2011 Council Appointment Date: March 22, 2011 After 11/15/10 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. AIRPORT ZONING BOARD OF ADJUSTMENT One Vacancy -Unexpired + 5-yr Term Ending December 31, 2011 Carl Williams resigned Gender Balance Requirement: None No applications as of Wednesday, 5:OOp.m., March 16, 2011 Denotes applicant completed the Confidential page of the application. 14b NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING BOARD OF ADJUSTMENT One vacancy -Five-Year Term January 1, 2009 -December 31, 2013 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, March 16, 2011. 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 Michael Tharp, Airport Operations Specialist at 356-5045. 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: 1 Council Announcement Date: September 23, 2008; November 3, 2008; December 16, 2008; February 10, 2009; March 10, 2009; April 6, 2009; May 19, 2009; June 16, 2009; July 28, 2009; September 15, 2009; October 20, 2009; December 1, 2009; January 25, 2010; March 2, 2010; April 6, 2010; May 10, 2010; June 15, 2010; August 17, 2010 (Gender Balance in Effect); September 21, 2010; November 16, 2010; December 7, 2010; January 10, 2011; February 15, 2011 Application Deadline: Wednesday, S:OOp.m., March 16, 2011 Council Appointment Date: March 22, 2011 After 11/15/10 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. AIRPORT ZONING BOARD OF ADJUSTMENT One Vacancy -Five-Year Term January 1, 2009 -December 31, 2013 Term expires for Dennis Keitel Gender Balance Requirement: None No applications as of Wednesday, S:OOp.m., March 16, 2011 D Denotes applicant completed the Confidential page of the application. 14c 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, March 16, 2011. 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 Cferk'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 Michael Tharp, Airport Operations Specialist at 356-5045. 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- taw, 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: 1 Council Announcement Date: September 20, 2005; November 1, 2005; December 13, 2005; January 23, 2006; February 28, 2006; March 21, 2006; April 18, 2006; June 13, 2006; August 1, 2006; September 5, 2006; September 19, 2006; November 14, 2006; December 12, 2006; January 9, 2007; February 20, 2007; March 20, 2007; May 1, 2007; June 5, 2007; July 24, 2007; September 18, 2007; November 5, 2007; December 11, 2007; January 29, 2008; March 11, 2008; April 14, 2008; May 13, 2008; June 17, 2008; July 15, 2008; August 26, 2008; October 6, 2008; November 18, 2008; January 6, 2009; February 24, 2009; March 24, 2009; May 19, 2009; June 16, 2009; July 28, 2009; September 15, 2009; October 20, 2009; December 1, 2009; January 25, 2010; March 2, 2010; April 6, 2010; May 10, 2010; June 15, 2010; August 17, 2010 (Gender Balance in Effect); September 21, 2010; November 16, 2010; December 7, 2010; January 10, 2011; February 15, 2011 Application Deadline: Wednesday, 5:OOp.m., March 16, 2011 Council Appointment Date: March 22, 2011 After 11/15/10 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. AIRPORT ZONING COMMISSION One Vacancy -Six-year Term January 1, 2006 -December 31, 2011 Term expires for Mark Anderson Gender Balance Requirement: None No applications as of Wednesday, 5:OOp.m., March 16, 2011 ~ Denotes applicant completed the Confidential page of the application. 14d NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: AIRPORT ZONING COMMISSION One vacancy -Six-yr Term January 1, 2010 -December 31, 2015 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, March 16, 2011. 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 Michael Tharp, Airport Operations Specialist at 356-5045. 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: 1 Council Announcement Date: September 15, 2009; November 2, 2009; December 1, 2009; January 25, 2010; March 2, 2010; April 6, 2010; May 10, 2010June 15, 2010; August 17, 2010 (Gender Balance in Effect); September 21, 2010; November 16, 2010; December 7, 2010; January 10, 2011; February 15, 2011 Application Deadline: Wednesday, 5:OOp.m., March 16, 2011 Council Appointment Date: March 22, 2011 After 11/15/10 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. AIRPORT ZONING COMMISSION One Vacancy -Six-year Term January 1, 2010 -December 31, 2015 Term expires for Brian Sponcil Gender Balance Requirement: None No applications as of Wednesday, 5:OOp.m., March 16, 2011 D Denotes applicant completed the Confidential page of the application. 14e NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF APPEALS One Vacancy- Five-Year Term January 1, 2009 -December 31, 2013 One (1) Mechanical Professional It is the duty of members of the Board of Appeals to hold appeal hearings on matters concerning the International Building Code, International Residential Code, Uniform Plumbing Code, National Electric Code, International Mechanical Code, International Fire 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 4:00 p.m. or at the call of the Building Official. Applications must be received by 5:00 p.m., Wednesday, March 16, 2011. 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. 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: Council Announcement Date: September 23, 2008; November 3, 2008; December 16, 2008; February 10, 2009; March 10, 2009; April 6, 2009; May 19, 2009; June 16, 2009; July 28, 2009; September 15, 2009; October 20, 2009; December 1, 2009; January 25, 2010; March 2, 2010; April 6, 2010; May 10, 2010; June 15, 2010; August 17, 2010 (Gender Balance in Effect); September 21, 2010; November 16, 2010; December 7, 2010; January 10, 2011; February 15, 2011 Application Deadline: Wednesday, 5:OOp.m., March 16, 2011 Council Appointment Date: March 22, 2011 After 11/15/10 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. BOARD OF APPEALS One vacancy -Five-Year Term (1) One Mechanical Professional January 1, 2009 -December 31, 2013 Term expires for Tim Fehr (Mechanical Professional) Gender Balance Requirement: None No applications as of Wednesday, 5:OOp.m., March 16, 2011 D Denotes applicant completed the Confidential page of the application. 14f NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD: BOARD OF APPEALS One Vacancy- Unexpired Term Effective Upon Appointment -December 31, 2014 One (1) Building Design Professional It is the duty of members of the Board of Appeals to hold appeal hearings on matters concerning the International Building Code, International Residential Code, Uniform Plumbing Code, National Electric Code, International Mechanical Code, International Fire 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 4:00 p.m. or at the call of the Building Official. Applications must be received by 5:00 p.m., Wednesday, March 16, 2011. 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. Spouses and relatives of City Council Members and members of comparable County Boards and certain 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: Council Announcement Date: January 10, 2011; February 15, 2011 Application Deadline: Wednesday, 5:00 p.m., March 16, 2011 Council Appointment Date: March 22, 2011 After 04/10/11 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. BOARD OF APPEALS One Vacancy -Unexpired Term Building Design Professional Effective Upon Appointment -December 31, 2014 (Unexpired term for Stephen Buckman) Gender Balance Requirement: Female No applications as of Wednesday, 5:OOp.m., March 16, 2011 ~ Denotes a completed application has been filed. 14 NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: HISTORIC PRESERVATION COMMISSION Four Vacancies -Three Year Terms March 29, 2011 -March 29, 2014 (2) At Large Representatives (1) Longfellow Representative (1) Northside Representative Duties of the Historic Preservation Commission include: conducting studies for the identification and designation of Historic Districts; reviewing and acting upon all applications for Certificate of Appropriateness; cooperating with property owners and city agencies regarding remedy of dangerous conditions; furthering the efforts of historic preservation in the City by making recommendations on preservation issues, when appropriate, by encouraging the historical, architectural or cultural value, and by encouraging persons and organizations to become involved in preservation activities. This Commission meets the second Thursday of each month at 5:30 p.m and, if necessary, the fourth Thursday of each month at 5:30 p.m. Iowa City appointed members of the boards and commissions must be eligible electors of the City of Iowa City. Applications must be received by 5:00 p.m., Wednesday, March 16, 2011. 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 Historic Preservation Commission should be directed to Christina Kuecker, Associate Planner at 356-5243. 1 /27/2011 ~ zoo ~~ ~ m ~~ Z ~~ ~~ v O N (D 7 `° c~. m 3 9 ~~ ~ Zc o ~ Qa 0 2 D rn ~ ~ -~ ~ ~ m ~_ D -i _ O D Z D ~ cn ~ n 3 O ~ m ~ Z 0 D cmn 3 n = c v 3 3 3 = Z ~_ v ~ ~ z Z rn ~ C ~ y ~ N v D O ~ Z z ~ ~ D 7C m ~ N -~ ~ D r v o m = 3 n 7C m ~ N Z z ~ D 3 m ~ N -I W N ~ ~' N W N ~ ~ W W N ~ .~ W N ~ N W N ~ O W N c`o N (` N co ~ W N ~ ~ W N ~ -~ N ~p ~ W W N CO ~ N W N CO ~ W N Cfl ~ W m 3 m ~ x x x x x O m X i x x x O ~ .'p x o m o 'm x x x ~ i x 0 m x 0 'm =' z z z z z z z ; z z z z x X x O m ; ~ x x i X X X X X ~ ~' c° c ~ 0 x x m x x x x x x x w X X p m p m ' x ~ i ~ x x X x v x x x x x ° ~ ~ O `m x x ~ m o~ o x x o m x ~ ' x ° x ° x x x x x Q m x ~ x X x ; m x x x N o m x x o m x x x i ~ x x x x x x ° x o m x ~ ° m x x x ~. x p m x p m ~ x x m ~ x x x x x x x x x x x m x x x O n ~o m m O z n 3 O z D m z v n z n m m n v 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: 4 Council Announcement Date: January 25, 2011 Application Deadline: Wednesday, 5:00 p.m., March 16, 2011 Council Appointment Date: March 22, 2011 After 04/25/11 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. HISTORIC PRESERVATION COMMISSION Four Vacancies -Three Year Terms March 29, 2011 -March 29, 2014 (2) At-Large, (1) Longfellow, (1) Northside Term expires for Andrew Litton, Thomas Baldridge, David McMahon, Dana Thomann Gender Balance Requirement: 2 Males, 1 Female, 1 None Longfellow District Representative (M) David McMahon D (Currently serving unexpired term) 425 Rundell St At-Large Representative (M) Thomas Baldridge ~ 915 Oakcrest No. 16 (Currently serving 1St 3-yr term) (M) Mark Hartstack D 1326 Yewell St (M) Andrew Litton D 331 N Van Buren St (Currently serving unexpired term) Northside District Representative (F) Dana Thomann D (Currently serving unexpired term) 208 Fairchild St D Denotes applicant completed the Confidential page of the application. r City of Iowa City ~_,;,,®~~ Advisory Board/Commission/Committee ~~""',~~ pplication Form CITY OF IOWA CITY 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 F`O,R ANY VACA~t DURING THAT TIME. Advisory Board/Commission/Committee Name ~i ~ 5f~U21~C ~"t7.2~e'~~a' ~' Term ~ U~t Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: Signature of parent/guardian: NAME .¢_~ ~ S~ -~..e.._ "~ ~~~~ ~ ~L~~a. ~ o~,... HOME ADDRESS ~ ~--~~ ~t-t-~'`~ Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes ~ No How long have you been a resident of Iowa City? 3 X;~S Gender: Male v "Female OCCUPATION ~Yr~~S ~ ~-`" EMPLOYER ~~ y'C~-- O PHONE NUMBER: HOME ~ ~~ ~13U'~" ~ C9 ~'Y BUSINESS 3~~1 " ~~ ` ~~' EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? 0 -~~ c~ -n WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FOR •` r.. I ? ..o.. 1 LIST POTENTIAL CONFLICTS OF INTEREST• See page 1 for information regarding Conflict of Intermit IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ©Yes ~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? 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. ~ ~ ~ ~,. ~,. General Application June 2010 Page 2 of 8 i~+®v7 ~III~~~ BOARD, COMMISSION AND COMMITTEES ~- ~ ,,,,M,®~~~ BUSINESS LISTING -K-~--- CITY OF IOWA CITY Name of City l - 5 f7J V2rCC ~ t<'L k~S ~C v ~'~~ ~~f"' Date ~'` -~'.' ( ~ Board/Commission/Committee Name ~ h.v 4 ~ ~2 . ~. G ~.Ct, h Oti~-- 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, your spouse/domestic partner, or parent if Youth AdvisoN Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. acquired in an additional business. Applicant Signature ~~^- Signature of parent/guardian (Youth Advisory Commission only): Address `'~ZS' ~~-~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 June 2010 Page 3 of 8 NOTE: A new form must be completed if the above information changes or an ownership interest is City of Iowa City ~ r 1 Advisor hoard/Commission/Committee ~',~~"',~`~~ Y '~ . ,~plication Form "'`-"- CITY OF IOWA CITY 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/Committee Name ~ ~ C ~~~~~1~"A-~C-~~'~~~L-~J~~~ ~~°' Term _____ Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: Signature of parent/guardian: NAM E HOME ADDRESS ~~.~7 ~~~~ fl/e• ~~ Is your home address (listed above) within the corporate limits of Iowa City? How long have you bee-n-_a~ resident of Iowa City? h i12' ~~t~~-_~~~tig1~' OCCUPATION "7f-Y.~.t~ eQ ~M P L01' R _ PHONE NUMBER: HOME ,~~c~_~~~~ BUSINESS ~ ~~ o EXPERIENCE ANDlOR ACTIVITIES WHICH YOU FEEL t~tUA~Ir-r rvu rvtc ~ n~~ rv~~ I ~s,a~. f ~~ CW1 ~~~ ~ti~ >;'~,I~~Y ~ ~-~e~;1~S d ~~~ ~~. u,~-i.~:-Pn ~ f~-~- N°-~ e f ~ ( '~' 0 :~r~T~ -o - - - r--s WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASUIV rvrcHrr~ru~u F .S c~ 4'1 ~--t` L~.- ~~. ,1~.2 ~.t`!~~ ~• ~/.) .~l~L •-~~rng -~P-Q-i-~ ~~ ~ ~~~ih ~-' J'~, ~~' L i i.~Y1.. ~-~-i,~vt; lX~-~cc~.$ ~5L4 -~ 1~ ~:.-' ~ i~v~.~cl.$vvt c ~~. Y~iv ~.~" ~~~ ~ ~ LIST POTENTIAL CONFLICTS OF INTEREST• See page 1 for information regarding Contlict of Interest / !'1L `~L-,~~~ ~[.ues.~~ ,~~>~.~. ~~c~i'v~r~, ~i.~.~` / ~,PL~'z.f1-e~~-tit ~e.!1~ ~. `~ L~~~~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~ Yes ~J No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes ~No nt naG hPPn C;nuncil nolicv not to permit an individual to serve on two Boards or Commissions at the same time.) I ~/Iisrepresentations on this application will constitute just cause for removal of an appointee. If you ail _o answer all the questions, Council may not consider your application. Yes ~ No Gender: Male ® Female General Application June 2010 Page 2 of 8 ~~ ~~I~'~~~-L~ilL~f GDS' ~L C~~ - r~ ?~~~ l r~ ~ ~' ~~ .~ ~ ~ ~~ /~~~-vim --~r-.~~~~~ lLc ~ ~ `~ `_ (~~~' ~~~~'' .d~2 ~"~iYZd t=om ~/~ ; . C~ ~Lt- ~Z a N O ~ ~ .~ ~ 1:57 7 ~ N F" ~ n ~ -~ f-' ~"t 'D ~ ~ ~ ~~ N ~' N CJ'1 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING ~ r 1 . ~.~.®~,~ .:III CITY OF IOWA CITY Name of City Board/Commission/Committee ~~ ~~ ~G ~"(n'~~~r `41'1 Date 1~ ~~ ~~ Name (..~ ~~~~~` S ~~e`~L1JTZ 1 %~~-~ 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, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, 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 0 o -*, :~ _~ w ,~ ~- ~` -~ m ;~ ~ ~ ~ N Cl~ NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signature L,(~t~?U~'~-Q- ~f ~~1~ Signature of parent/guardian (Youth Advisory Comm on only): 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 June 2010 Page 3 of 8 City of Iowa City ~ r i _.:.®~ Advisory Board/CommissioniCommittee ~: -"' ~~ ,~ ~,®.~i 4pplication Form "`-"-- CITY OF IOWA CITY 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 tANY V~A~CANCY DURING THAT TIME. Advisory Board/Commission/Committee Name ~iS~ct;L ~~S~fJ•cT,tl~~ C~Nimisio~l Term.' '~ ~~~ ,. Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: Signature of parent/guardian: NAME ~Y1Ai21< NARTST/~CIC HOME ADDRESS Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes ~ No How long have you Breen a resident of Iowa City? ea.~ Gender: Male ~ Female OCCUPATION ~t ~.~h0~~ ~' EMPLOYER PHONE NUMBER: HOME .311` ~ y 13RD ~ BUSINESS C~/1S'~f~nC}i ~°` l ~ a~~U ~a~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ~ 2~ ~A 5~,1 e~ ~ ~ ;w en, s we . ~ a ~a ~ r~ e 12 ~~' ~~ rS, " t,~,r~'-~,t~ a,, J-~zw ~tww1'~, t'ti;~~'~n; c: c1~3`~';c~-s , ~~1~ L?.~rktcl w> -~-b.c ccv~n~.,~ss~`~ e'^ ~~ '~ nn i~~~1 ~ ~ec"~ ~ 11 ~ C~-'~ ~y;y.~ ~r `'~,~s~~'~` "I-p ~-~ ~4~r~ ~'/~ 't'~~c l'~-hf!~G~~ edr~, urunT is vnr iQ ~aFCFnIT KNnWI FOGF DF THIS ADVISORY BOARD? .....-.. ~- l~a~e. ~.'~c~ rnan~ ~~te.ra i~ '~~ ,,,~~t +~ bca~ ~ e 1 -1-he~ ~/~ i~~es~ v-~c~sra'~ WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FORAPPLYING ? C rwu~r cr„ t{ ~`'^er ~~~"~v.~ C'2 s'~~5 . 1-- ~~~1-e ~~. ~ ~ ~s Vl~ m~t~. ~ 1 ~ ,r ~C ~h 6~ o~ ~ h m~~~s , .1 L,' ~~e. i1, z /~;~'~fl r.: ~ ~~. ~ ~- LIST POTENTIAL CONFLICTS OF INTEREST: See a e 1 for information re ardin Conflic~~nt~st S ~ ~ -v ~~~~~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes U Nom' DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? 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. ~neral Application June 2010 Page 2 of 8 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING _~ r ',~®.~~ -•~...~ CITY OF IOWA CITY Name of City ~,SI~ . 1 Board/Commission/Committee ~~ G I^r7S(? (,i?%ll~o'lr ~b~~r~ ~ ss~\~" Date 3 ~ r ~ Name ~1,~ ~~.4, t'~ ~R~~~~ 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, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, 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 6a~ ~ ~ r~n~AIJ 1.2t; ~~~~ s; . -'~ ~ -az~6 ~~ ~,-~. ~~-- ~~ ~ ~ a NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signature Signature of paren Address 132 uardian (Youth Advisory Commission only): 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. •neral Application June 2010 Page 3 of 8 city of Iowa city _ , r Advisory Board/Commission/Committee ~"r ~'I~~ Application Form -~-- CITY OF IOWA CITY 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/Committee Name ~,{~~~-,tr~~= z.. ~"~~ ~~ ;~~..aa ~ ~~- ~:%:~..~Term Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: Signature of parent/guardian: NAME ~~~~~~~ f/ c" ~`-~•~ HOME ADDRESS ~+~f ~ ~~-i ~,~c:9•/'~-~~ ~ ~`' ~-z..~ Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes ~ No How Tong have you been a resident of Iowa City? ~, `` (~ . !.•c-~,~-~ Gender: Male ~ Female OCCUPATION ? ~.E~t. I ~ ~ EMPLOYER ~~ c'r.~ ~~.;e~ I PHONE NUMBER: HOME -7 ~`~-~ ~f -- 7~2.. BUSINESS ,~~~ ~- ~ ~"~ S~ EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: -~.~%t..~ ~L.. ~'~ct ~ i? ~i ~/'tI ?``Y°~iSr ut-~l ec~ i_.c.' ~-'~-G'~- l t `v-~ ~ U° +~ I~, WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? WHAT Cff ONTRIBUTIONS CAN YOU )MAKE TO THIS ADVISORY~B~IO~ARD RjE~ASON FORAPPLYING ? C.~-- V~,L~~/~. '~~ j C7 ~ ~! S LrU~f • eg~'l 6-mil, i s t/~c`JCZ r'~ `~"` ~ ~ v~ "`'- ti1i- fi~-~ ~ ~ ~5 ~~ '~- r27~[ v S. ~°' ~~/fit, ~~ G1~ ~i LIST POTENTIAL CONFLICTS OF INTEREST: See a e 1 for information re ardin Conflic f Interest `~.---~- C7 - .~ ~~"` IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? Yes ~'"°?" ~ DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSI? ~ Ye~ ~lo (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 ''o answer all the questions, Council may not consider your application. ~~ General Application June 2010 Page 2 of 8 ~ r -~.®~r BOARD, COMMISSION AND COMMITTEES ~ ~.'i°~~'~~ BUSINESS LISTING .,,,~,,~_ CITY OF IOWA CITY Name of City ~` ~~ Board/Commission/Committee `, ?~~~~ ~~ ~~S ~'~"~ fi!~'c 1~c~~ ~, Date ~~ ~"' Name '~ ~ ..--~ 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, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, 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 N O ~ _.... 's r-- ~' ~~ ~~ ~ ~ 'S' a NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. ~.; Applicant Signature / ,0°' Signature of parent/guardian (Yo Address "~,~ ~ ~(~. (~,~,,~ Advisory Commission only): .~ ~~ 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 June 2010 Page 3 of 8 Glt~/ Ot IOW1 Glt~/ 1 r 1 ~~:.®~r Adviso Board/Commission/Committee ~; ~"'~`'~~ ry ,~~,•~ Application Form ~`-"- CITY OF IOWA CITY 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/Committee Name r,~~ /~/~l ~ ~i'~~~l~~L~--~~YI Term Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: Signature of parent/guardian: ~. . NAME ~QI'7l' T~M,C.2 r~ n HOME ADDRESS I QIIP('h~'lC/~~`1r Is your home address (listed above) within the corporate limits of Iowa City? Yes ~ No How long have you been a resident of Iowa City? ~t.~~ ,2C~'/ Gender: Male ~ Female' OCCUPATION i EMPLOYER ~~f PHONE NUMBER: HOME I~1 ~ BUSINESS _ O N EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:° 1~11/(, l~ Q hjCS~r1C' G~iC.Sr~') ~ f "' ~c~ rn "`~"~ _~ N • (~. 7 Q i~f~~ ire ~~~ ~xS~iC C~~~~~~" ~--~ ~ ~ ~~ _ -r ~ WH~ IS'YOUR PRESENT KNOWL DGE OF THIS ADVISORY BOARD? ~~ ~ ..~ {~ ~~- ~S~rU~d o~ .e- ~~rm v~ ~th ~ C~ m n~~s~'sr~ ..L am fzzm~"I ic~~. tv ~t~ the- ~Jic.Sf~ric e.~~a' e~!l~~i~ ~-~~~>%~sY~~' WH~4T CDNTRI UTSCANYOU MAKE TO THIS ADVISORY BOARD (REASONFORAPPLYING)? ~ ~ ~~~~j~ ~f~ C3ol~~~~~~ ~n ~t-h ~ ~~~ m ~ ~ s ~ ~~o ~ ~c~z u s -~- ~ e-~Joy ~ raorct jr~ ~~he- ~icS~Y-i c ~r~e~ ~~~~ ~~ LIST POTENTIAL CONFLICTS OF INTER See page 1 for inforriiafion regardin~onof Interest ~~~ V C-~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? `~ Yes ~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes ~No (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) "~srepresentations on this application will constitute just cause for removal of an appointee. If you fail .~ answer all the questions, Council may not consider your application. General Application June 2010 Page 2 of 8 ~~ r 1 "~° ~r~~~ BOARD, COMMISSION AND COMMITTEES ~~®~~~ BUSINESS LISTING ••n.a~ CITY OF IOWA CITY Name of City Board/Commission/Committee ~~1~~n~ ~r~~'~-~~~.~7(1~ Date ~'f Name ~M' ~~701'Y~l~l'7 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, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, 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 W "`=.~ fTl ~7 -C N --C r"` ~~ ~ .. 'Ca NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additi~n I business ~~ Applicant Signature l1 ~ Signature of parent/guardian (Youth Commission only): 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 June 2010 Page 3 of 8 14h NOTICE THE CITY OF IOWA CITY IS CONSIDERING AN APPOINTMENT TO THE FOLLOWING TASKFORCE: Metropolitan Planning Organization of Johnson County (MPO) Community Climate Action Taskforce (formerly Cool Cities Taskforce) One At-Large/Public Position -One Year Term Effective upon appointment- March, 2012 The Metropolitan Planning Organization of Johnson County (MPO) is seeking a representative to participate on the MPO Community Climate Action Taskforce to provide guidance to MPO member communities choosing to participate in the Sierra Club's Cool Cities Program. The Cool Cities Program is a voluntary program by which local governments work to reduce greenhouse gas emissions created by municipal facilities and vehicle fleets. The duties of the MPO Community Climate Action Taskforce are to advise on the development of action plans for participating communities so that each entity can work proactively to obtain a Cool Cities designation. The Iowa City appointed representative must be a resident of Iowa City, Iowa. The Community Climate Action Taskforce will meet no more than once per month, after appointments are made. Applicants should be advised that this is a voluntary taskforce with meetings held in Iowa City, and/or neighboring communities. The ideal candidate will have a mix of expertise in appropriate fields such as: education, business, building trades, architectural design, environment, transportation, non-profit human services and/or the faith community. Applications must be received by 5:00 p.m., Wednesday, March 16, 2011 at the Iowa City City Clerks office at 410 E Washington Street, Iowa City, IA. The MPO Urbanized Area Policy Board will make final appointments. Application forms may be obtained at the Iowa City City Clerks office or on the Iowa City Website www.icgov.org. Questions about the MPO Community Climate Action Taskforce should be directed to Kent Ralston at 319-356-5253. 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) Council Announcement Date: February 1, 2011 Application Deadline: Wednesday, 5:00 p.m., March 16, 2011 Council Appointment Date: March 22, 2011 Metropolitan Planning Organization of Johnson County (formerly JCCOG) MPO Community Climate Action Taskforce (formerly Cool Cities Taskforce) One Vacancy -One-Year Term Ending March 2012 Term expires for Thomas Carsner Thomas Carsner ~ 1627 College Court Place ~ Denotes applicant completed the Confidential page of the application. City of Iowa City ~ r i Advisory Board/Commission/Committee ~,~I`'~~ Application Form "`-"- CITY OF IOWA CITY 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/Committee Name JCCOG Climate Action Taskforce Term 3/11-2/12 Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: Signature of parent/guardian: NAME Th.,n,a~ ~arsner HOME ADDRESS 1627 College Court Pla e Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes ~ No How long have you been a resident of Iowa City? 45 years Gender: Male ~ Female OCCUPATION Editor EMPLOYER ACT. Inc. PHONE NUMBER: HOME 319-338-9335 BUSINESS EXPERIENCE ANDIOR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ember Executive Committee Iowa City Area Group, Sierra Club 2005-present ~-Chair Cool Cities Task Force of Iowa City Sierra Club 2006-present; Board Member, Friends of Hickory Hill Park ember I-SOARR 1997-present (county roads, rural residential and commercial development) ;Board Member EA uiu wr ~c vn~ ~~ oQGC~MT KNnWI FnrF (]F THIS ADVISORY BOARD? have served on this committee since its inception in 2009 and actively participated in its meetings and activities. As a leader in the local Sierra Club I lobbied for the creation of this taskforce to help local governments implement the Cool Cities plan of reducing carbon emissions by local governments and residents. wHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FoRAPPLYIIV~~-r , want to continue the momentum of the taskforce as Iowa City and Johnson County have completed their carbon audits and other entities continue their efforts. We want to form citizen committees to create a carbot~eduction plan for the City Council to approve and implement. I have attended two national conferences an Q y pas'~on grows. .~-_ ~ -~ LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict~~ 1~1~ter w t x~~ctir~c~ ~~ ~ ,-~, -~ IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? a Yes ~No ~'~ DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? 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. ~neral Application June 2010 Page 2 of 8 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee JCCOG Climate Action Taskforce Name Thomas Carsner 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, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. acquired in an additional business. Applicant Signature Signature of parent/gu Advisory Commission only): Address 1627 College Court Place 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. ~Q~~®~ :.III~~~ CITY OF IOWA CITY Date 02/02/2011 _aneral Application June 2010 Page 3 of 8 NOTE: A new form must be completed if the above information changes or an ownership interest is 14i NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: TELECOMMUNICATIONS COMMISSION ~~~' one Vacancy -Three Year Terms March 13, 2011 -March 13, 2014 The duties of the Telecommunications Commission include serving as a review board to resolve disputes between any subscriber or potential subscriber and the cablevision company; reviewing and auditing reports by the cablevision company to the City as required by the Cable Television Ordinance; working with the public, the media, the City, and the cablevision company for the purpose of making recommendations on various issues; engaging in other activities pursuant to the effective monitoring and evaluation of the CATV system in the City. Iowa City-appointed members of boards and commissions must be eligible electors of the City of Iowa City. The Telecommunications Commission meets the fourth Monday of each month at 5:30 p.m. Applications must be received by 5:00 p.m., Wednesday, March 16, 2011. 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 Telecommunications Commission should be directed to Bob Hardy, Cable Television Administrator at 356-5047. TELECOMMUNICATIONS COMMISSION 12 MONTH ATTENDANCE RECORD July 2008 to CURRENT Meetin Date Hoerschelman Saul Meikes Bob Kem Gordon Ga Ha en 7/2g/Og X X X X X 8/25/08 X X X o/c X 9/23/08 x x x x X 10.27/08 X X X o/c X 11/24/08 Did not meet 12/15/08 X X X X X 1 /26/09 X X X X o/c 2/243/09 X' x o/c o/c X Laura Ber us 4/27/09 X X X X X 6/1/09 x x x vacant X 6/22/09 X X X X Mekies 7/27/09 X X X o/c x 8/24/09 X X X X X 9/28/09 X X X X X 10/24/09 x x xx o/c 11 /23/09 x x o/c x X 1 /25/10 X X X o/c o/c 2/22/10 X X o/c X o/c 4/26/10 X X o/c X o/c 5/24/10 X X 0 X X 6/28/10 X x 0 X o/c 7/26/10 X x 0 o/c X 8/23/10 X X Vacant X X 9/27/10 o/c x x X 10/24/10 X o/c X X Klouda 11 /22/10 X X X X X 12/27/10 X X X X o/c 1 /24/ 11 X X X O X 2/28/11 X X X X X (X) =Present (O) =Absent (O/C) = Absent/Called (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: 2 Females: 1 Council Announcement Date: January 25, 2011 Application Deadline: Wednesday, 5:00 p.m., March 16, 2011 Council Appointment Date: March 22, 2011 After 04/25/11 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. TELECOMMUNICATIONS COMMISSION Two Vacancies -Three-year Terms March 13, 2011 -March 13, 2014 (Term expires for Nolan Klouda, Gary Hagen) Gender Balance Requirement: 1 Female (M) Gary Hagen ~ (Previously served two 3-yr terms) 2128 S Riverside Dr #125 (M) Nolan Klouda D (Previously served unexpired term) 309 Finkbine Ln, Apt 9 ~ .Denotes applicant completed the Confidential page of the application. City of Iowa City ~ r 1 rw~~~ A Advisory Board/Commission/Committee ~.,~`'~~ ':~ pnplication Form "~-"- CITY OF IOWA CITY 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/Committee Name Telecommunications Commission Term 2011-14 Youth Advisory Commission {shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: Signature of parent/guardian: NAME Gary Hagen _ HOME ADDRESS ~~ ~A c Rivarciria flr #125 Is your home address (listed above) within the corporate limits of Iowa City? ~ Yes ~ No How long have you been a resident of Iowa City? go years Gender: Male ~ Female OCCUPATION p~ anagPr~c+nrcC 1 IIH(: yRatira~J~ EMPLOYER U of Iowa Healthcare PHONE NUMBER: HOME 319-337-3545 BUSINESS ni/p EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: v 6 spars on the commission and a communications degree from the UI. - ~ ~_• °~ Z ~~~ a WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? ;,~`~ ago 6 years experience N CJ7 WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)? I feel I have an excellent grasp of the issues and I speak my mind. LIST POTENTIAL CONFLICTS OF INTEREST• See page 1 for information regarding Conflict of Interest None ~i IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? U Yes (~ No DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? Yes QNo (It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.) "~isrepresentations on this application will constitute just cause for removal of an appointee. If you fail answer all the questions, Council may not consider your application. General Application June 2010 Page 2 of 8 BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee Telecommunications Commission ~~ r i :rm~ -•a.a.__ CITY OF IOWA CITY Date ~ -27~ ~~ Name Gary Hagen 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, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, 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 1 c... v O S~ ~l,,.i+~ ~ r ~~., »~ ~ ~? ~'° N t NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signature Signature of parent/guardian (Y Advisory Commission only): Address 2128 S. Riverside Dr.#125 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 June 2010 Page 3 of 8 City of Iowa City ~ ~ r 1 ~.:~.:~ ,Advisory Board/Commission/Committee ~` -~"'~"~'~~ ~~~~~ Application Form ~~-- CITY of lowACITY 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/Committee Name ~t'~le~,r~rr;mr.~nic~,atiti,r~ts Comrr7ission Term 2011 2014 Youth Advisory Commission (shall not be more than 18 years of age at the time of application) Name of Iowa City High School or high school equivalent: ° 0 Signature of parent/guardian: n a NAME Nolar7 I<louda HOME ADDRESS 303 FinlEbine Ln ~ 9 w fir." Is your home address (listed above) within the corporate limits of Iowa City? ~ ~~ How long have you been a resident of Iowa City? 1 year, 8 r-noriths Gende~Vlale Female OCCUPATION c,~stcr~ner 'service EMPLOYER ACT PHONE NUMBER: HOME 78~ 76G 6058 BUSINESS NA EXPERIENCE AND/OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION: ICII-- have an r/d~acatior~ irr local. gover~nr~~er~~t adrr~ir~istr<~ti~r7 and i Lava ser~ded on the Tele~ommunicati~a~7s Commission Ifc '3out three months. WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? - _ _-- Havinc,~ ~;r?r1tE?c~ Qn the br?ard for aho~~t tl~rE~e rncnths, 1 t~aue gained some familiarity with the commission, its ~~nernl~~ers, city staff, arltt if;e TV fi~ar~cE:~ise. WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS_ADVtSORY BOARD_~REASON FORAPPLYING~? ~____,._ I an~~ I`iighly intereste~ci ire city gc~.fernr7~er~t ar;d matters of infrastructure anei technology policy. I offer a sense of nquitiitivr;rress, kr~r~+rrledge c~fihaoal gc~vPrr~~rnent, ar~r_? a fresh perspective. LIST POTENTIAL CONFLICTS OF INTEREST~See Eage`1 for information regardin~Conflict of Interest _~ __ I I IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ~/ Yes ~ No , DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? ~ Yes ~/ No (It has been Gouncil policy not to permit an individual to serve on two Boards or Commissions at the same time.) Misrepresentations on this application wiN constitute just cause for removal of an appointee. If you fail answer all the questions, Council may not consider your application. n~.~.....; , ..~ rte.. .... , .., ,.. _. _ . . General Application ~~ June 2010 Page 2 of 8 ~~'~ BOARD, COMMISSION AND COMMITTEES BUSINESS LISTING Name of City Board/Commission/Committee ~~e ~cua~7trunicaticr,s C'.a~~r~~r,is~ion Name ~f~~ar~~ K c~uda 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). NOTE: A new form must be completed if the above information changes or an ownership interest is acquired in an additional business. Applicant Signature, Signature of parerit/guardian (Youth Advisory Commission only): Address 309 Finkbinc Ln Apt 9 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. ~..~.~ nrr®"~ •-~a~s._ CITY CJ1= IOWA CITY Date Z- j General Application June 2010 Page 3 of 8 List all businesses in which you, your spouse/domestic partner, or parent if Youth Advisory Commission applicant, have an ownership interest (for example, sole proprietor, partner, 5% or more of corporation's stockholdings). Please indicate if there are none. 14' NOTICE THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION: YOUTH ADVISORY COMMISSION One Vacancy -Two-Year Term January 1, 2011 -December 31, 2012 One (1) person -Tate High The mission of the Youth Advisory Commission is to promote understanding and awareness of Iowa City among Iowa City youth, allow a select group of youth to help make decisions concerning them and their peers, enable youth members to utilize and expand on their leadership abilities, to serve as a mechanism for communication between youth and adults in Iowa City and create a bridge whereon youth and adults can develop partnerships. Membership shall consist of seven [7] members appointed by the City Council currently enrolled in an Iowa City high school or high school equivalent. Four members shall represent City, Regina, Tate, and West high schools. The three remaining members shall be at large. All ages shall be calculated on the date of the filing of applications, and shall not be more than 18 years of age at the time of application. All members shall be residents of Iowa City. Applications must be received by 5:00 p.m., Wednesday, March 16, 2011. 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.orq. Questions about the Iowa City Youth Advisory Commission should be directed to Marian Karr, City Clerk at 356-5041. 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: 3 Council Announcement Date: October 26, 2010; December 7, 2010; January 10, 2011; February 15, 2011 Application Deadline: Wednesday, 5:OOp.m., March 16, 2011 Council Appointment Date: March 22, 2011 (Recommendations to be made by Councilliaison) After 01/24/11 (3 mo from the announcement date) Council may appoint any qualified applicant without regard to gender. YOUTH ADVISORY COMMISSION One Vacancy -Two Year Term January 1, 2011 -December 31, 2012 One (1) person -Tate High Gender Balance Requirement: None No applications as of Wednesday, S:OOp.m., March 16, 2011 ^x Denotes applicant completed the Confidential page of the application. 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- la ,father- in- law, brother, sister, brother- in- law, sister- in- law, step-father, step-mot ei~ step-child, aunt, or uncle. (Resolution 85-354) Males: 1 Females: 1 Council Announceme t Date: September 23, 2008; November,, 2008; December 16, 2008; February 10, 2009; March 10,;-2009; April 6, 2009; May 19, 2009; June 16, 2009; July 2;~; 2009; September 15, 2009; October 20, 2009; Decet~p.tier 1, 2009; January 25, 2010; March 2, 2010; April 6, ~b10; May 10, 2010; June 15, 2010; August 17, 2010 (Gender Balance in Effect); September 21, 2010; November 16,;'2010; December 7, 2010; January 10, 2011; February 1~5;~2011 Application Deadline: Wedne: Council Appointment Date: M After 11/15/10 (3 mo from the ar without regard to gender. AIRPORT ZONING BOARD OF 5:OOp.m,!~March 16, 2011 22, 20 ~ncem nt date) Council may appoint any qualified applicant STMENT One Vacancy -Five-Year Ter January 1, 2009 -December , 2013 Term expires for Dennis Ke' el Gender Balance Requir ment: None No applications s of Wednesday, 5:OOp.m., 16, 2011 ~ D;~notes applicant completed the Confidential p~ge of the application.