HomeMy WebLinkAbout2012-02-21 AppointmentM 25a
:I
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
BOARD OF ADJUSTMENT
One vacancy — Unexpired Term
Effective Upon Appointment— Ending January 1, 2014
Duties: In appropriate cases and subject to appropriate conditions and safeguards, the Board
may make special exceptions to the terms of the Zoning Chapter in harmony with the general purpose and
intent of the ordinance and in accordance with general or specific rules contained therein. The Board may
grant variances to the Zoning Chapter only in the case of "unnecessary hardship." The hardship must be
substantial, serious, real, and of compelling force, as distinguished from reasons of convenience,
maximization of profit or caprice. The Board may also hear and decide appeals where it is alleged there is
an error in any order, requirement, decision, or determination made by a City official in the enforcement of
the Zoning Chapter.
Iowa City appointed members of boards and commissions must be eligible electors of the City of
Iowa City. The Board meets the second Wednesday of each month at 5:00 p.m.
Applications must be received by 5:00 p.m., Wednesday, February 15, 2012. 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 Board of Adjustment Commission should be directed to Sarah
Walz, Associate Planner at 356 -5239.
7
m
zoox
u r. m u u
Z 11 > -U
0 Q N W
(D CD
9(D
(D CD C
3 x
QCO 0
CD z
0 m
Q-
0
3
0D:*Woo
zz
0)
c:L
3
��C
-0Q'
m
CD
CD
T�
G)
v
�m
cc
�.
mM�'`�
to
0
CD
00O0o
m
1
N
N
-A
N
-A
N
-A
N
m
55 M
00000
-A
-A
-A
m 3
W
NCJ7��
N
x
;
xxx
='
xxxxx
o
xxxxx
L
W
xxxxx
xx�xm
w
m
x
x
x
x
x
A
Dca
>O
D
zo
DN O
Z
m`
�c
m Cl)
O3
�m
vz
-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: 3
Females:
Council Announcement Date: January 10, 2012
Application Deadline: Wednesday, 5:OOp.m., February 15, 2012
Council Appointment Date: February 21, 2012
After 04/09/2012 (3 mo from the announcement date) Council may appoint any qualified
applicant without regard to gender.
BOARD OF ADJUSTMENT
One vacancy — Unexpired Term
Effective Upon Appointment — January 14, 2014
Barbara Eckstein resigned
Gender Balance Requirement: 1 Female
(M) Adam Plagge Fx1
414 Brown St, Apt 4
El Denotes applicant completed the Confidential page of the application.
City of Iowa City _ I r ,
Advisory Board /Commission /Committee
pnplieation Form -n-�-
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 Board of Adjustment 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 Adam Plagge HOME ADDRESS 414 Brown St Apt 4 Iowa City IA 52245
Is your home address (listed above) within the corporate limits of Iowa City? 0✓ Yes R No
How long have you been a resident of Iowa City? 1.5 years Gender: Male 0✓ Female F]
OCCUPATION Student EMPLOYER University of Iowa
PHONE NUMBER: HOME 515 - 343 -7424 BUSINESS
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I - viously served as a board member and am currently a masters candidate in University of Iowa's Urban Planning
a. OBA programs. C s e —eo! a n i o -;011 -f o- a ti "(Op r l e4ed i e+k, )
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
Having served previously and taken course work geared towards quasi judicial bodies I feel I have a solid
understanding of the role the BOA plays in city governance.
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FOR APPLYING ?
The ability to contribute in making equitable and judicially sound decisions.;
rte;
LIST POTENTIAL CONFLICTS OF INTEREST: See naae 1 for information renardina Congi�i of Irif�rPCt j
Previously a consultant for Prestige Properties.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 0 Yes r-1-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.)
9isrepresentations on this application will constitute just cause for removal of an appointee. If you fail
co 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 Board of Adjustment
Name Adam Plagge
I r 1
Mqp.
CITY OF IOWA CITY
Date 12/22/2011
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
r
E -1J d
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additional business.
Applicant Signature b441111
Signature of parent /guardian (Youth
ry Commission only):
Address 414 Brown St Apt 4 Iowa City IA 52245
Misrepresentations 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 3 of 8
L02-21-1
25b
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
BOARD OF APPEALS
One Vacancy— Five -Year Term
January 1, 2012 - December 31, 2016
One (1) Mechanical or Building Design Professional
Or
A qualified trade representative,
(if after 3 months no professional applies or is appointed)
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, February 15, 2012. 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.
XI
ZO'OXTs
KC)Cn�D'C
ii
n
mj
ii
n
o
�I�
:3
u
nlvv
cl—:3
X
=
col°
z
°�'z3
a)
N
m
,�
C) �
v
1Q
�z
m°'
3
N
CD
330=4a0
-
-0 7
N
O
N'
D
s
O
a!
ICD
--
CD
cD
O °'�
n
=''
o
m
v
m
m-
OL
m
I
W
N
W,W W
N
W
1,111,
m
N
O
N''N N
O O O
N
O
X
cnW�NN
m
__
co
z
3
T
TI
Z
CD
I
s
j
z
ju
1
Z
I
I
i
i
Z�
X
O x X
X ca
I
I
II
1
D
0
X >
c
X ca
N
y
i
I
zD
s
i
4O
I
—
I
-'
1
T
jZ
0
v
CD
rMIL \V O
W
/0 -h
m D
;u 'a
cD mO
n CD
o
M �'
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:
Council Announcement Date: November 1, 2011; January 10, 2012
Application Deadline: Wednesday, 5:00 p.m., February 15, 2012
Council Appointment Date: February 21, 2012
After 01/30/2012 (3 mo from the announcement date) Council may appoint any qualified
applicant without regard to gender.
BOARD OF APPEALS
One vacancy - Five -year Term
January 1, 2012 — December 31, 2016
Term expires for Scott McDonough
Gender Balance Requirement: 1 Female
Mechanical or Building Design Professional; Or a qualified trade representative,
if after 3 months no professional applies or is appointed
Scott McDonough Fx1
10 Bella Vista PI
0 Denotes applicant completed the Confidential page of the application.
Advisory Board /Commission /Committee; A% sewn 0
Anplication Form
CITY OF IOWA CITY
THIS APPLICATION IS A PUBLIC DOCUMENT AND AS SUCH CAN BE REPRODUCED AND DISTRIBUTED FOR THE PUBLI,
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 board of appeals Term 2012
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 Scott McDonough HOME ADDRESS 10 Bella Vista PI
Is your home address (listed above) within the corporate limits of Iowa City? a Yes F] No
How long have you been a resident of Iowa City ? 2s 1fs Gender: Male 0 Female
OCCUPATION contractor EMPLOYER McDonough Structures
PHONE NUMBER: HOME 319- 631 -0405 BUSINESS s1 a-
s» -s4Ai
N
G7
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POTION:
am a current member of this board
=
eT
co
65 r'ko-*�
U
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I am a current member of this board
CD
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYING)?
I'm a very practicle person
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
none
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? [V Yes F No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? RYes ✓QNo
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
.Asrepresentations 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
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board /Commission /Committee board of appeals
Name Scott McDonough
®�%i:�(
CITY OF IOWA CITY
Date 12 -8 -11
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
McDonough Structures
340 Highland Ave. I C, IA 52240
CD
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 (Youth Advisory Commission only):
Address 10 Bella Vista PI
"Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
_i answer all the questions, Council may not consider your application.
General Application
M1
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
HISTORIC PRESERVATION COMMISSION
Four Vacancies — Three Year Terms
March 29, 2012 - March 29, 2015
(1) At Large Representative
(1) Woodlawn Representative
(1) College Green Representative
(1) East College 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, February 15, 2012. 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.
1/26/2012
1 zo u
ox
119-11 m
z 11 u D
°0cr
CD CD
�m :3
CD CD C--
3 m
SR 0
z C: O N
(D
0a
c
0
2
3
0
D
3
m
n
D
=
0
z
D
D
N
D
c
m
3
m
v
9
0
&
=
z
D
0
r
p
z
D
z
m
O
z
0
r
D
m
m
m
cn
m
X
D
v
m
O
n
m
O
z
rn
z
D
m
cn
--I
CA)
w
w
w
w
w
w
w
w
w
w
m
N
CO
N
N
C0
w
N
t0
N
(0
N
N
CD
N
N
GO
N
CD
N
(0
w
N
(0
N
N
CO
�
N
t0
W
X
x
m
x
m
x
x
o
m
x
x
m
x
x
w
x
x
O
O
O
x
x
O
x
x
x
o
x
x
x
x
x
x
x
x
x
w
a
x
x
x
x
x
x
x
x
x
x
x
m°
x
x
x
x
x
x
x
cn
°
m
x°
m
x
x
m
x
x
m
x°
m
°'
co
x
x
m
x
x°
x
x
x
x
x
x
m
x
x
x
x
x
x
x
co
x
x
x
x
x
x°
x
x
M
CO
x
x
m
x
m
m
x
x
x
x
w
x
x
x
x
x
x
x
°°
x
x
x
x
x
x°
x
x
x
x
x
x
0
D
m
z
v
Nz
on
�m
X
m
n
v
cn
O
X
n
X
m
cn
m
D
0
z
n
3
cn
N
0
z
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: 5
Females: 2
Council Announcement Date: December 6, 2011; January 24, 2012
Application Deadline: Wednesday, 5:OOp.m., February 15, 2012
Council Appointment Date: February 21, 2012
After 03/05/2012 (3 mo from the announcement date) Council may appoint any qualified
applicant without regard to gender.
HISTORIC PRESERVATION COMMISSION
Four vacancies — Three -Year Terms
(1) At -Large Representative
(1) Woodlawn Representative
(1) College Green Representative
(1) East College Representative
March 29, 2012 — March 29, 2015
Term expires for Frank Wagner, Ginalie Swaim, Pam Michaud, Esther Baker
Gender Balance Requirement: 3 Females, 1 None
(1) College Green Representative
(F) Pam Michaud El
109 S Johnson St
(1) At -Large Representative
(M) Frank Wagner 0
1724 Muscatine Ave
(1) East College St Representative
(F) Esther Baker El
1022 E College St
(1) Woodlawn Representative
(Currently serving 1 st three -yr term)
(Currently serving 1 st three -yr term)
(Currently serving 2nd three -yr term)
(F) Ginalie Swaim El (Currently serving 1 st three -yr term)
1024 Woodlawn
El Denotes applicant completed the Confidential page of the application.
City of Iowa City I Akz r
Advisory Board /Commission /Committee k s
lm�ft t -)plication Form CITY OF 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.
/� f C-o-%
Advisory Board /Commission /Committee Name � x ,ri'� Pi^�SUtrUetlqr1 (&'h /SS ce�Term -� en
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 Ilo en // I I /l.I /\ CLU--ty HOME ADDRESS /0V
=? X16
Is your home address (listed above) within the corporate limits of Iowa City? I Yes r] No
How long have you been a resident of Iowa City? 3 e4rS Gender: Male Female
OCCUPATION la-11 EMPLOYER.,SL/ T"
PHONE NUMBER: HOME = /� 7 /a y / BUSINESS P Us in
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
qs
fd Lt% D / �3� t� ✓l Ca
ern ltl'Lt.l'G%S Xj(/1 7 mA
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
GQ .tea S
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FORAPPLYING ?
1c�0i ��.v ✓t /,,e ul jc�r7�v��+viS3� C9' �C�oSI �n�f/
.� 'e- 'a (c a�-( �v� ((T r��{ G� e c—r� 0r, i nU i ✓ GC�s7�7'!i `' C� ra. /1 0
�q 1P�e.�2i( �a� c �.L21U✓Y, C�IQ.I / ` �J
LIST POTENTIAL CONFLICTS OF INTEREST: See paqe 1 for information reqardinq Conflict;6f Interest
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---- 4 No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions-at the ,u ame time.)
Misrepresentations 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
January 2012 Page 2 of 8
� r
BOARD, COMMISSION AND COMMITTEES,,"`1 °�
BUSINESS LISTING
CITY OF IOWA CITY
Name of City � n It J") S— /)
Board /Commission /Committee 7 /' lCr- ri -25� V,';u y Date
Name
/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
O 2 S-
- - r '
1 GO
U 0
=N
NOTE: A new form must be completed if the above information changes or an owhershiplinterest is
acquired in an additional business.
Applicant Signature
Signature of parent/guardian (Youth Advisory Commission only):
Address /0 i � J o n n -ST;
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
January 2012 Page 3 of 8
City of Iowa City _ r
Advisory Board /Commission /Committee 4k cwh
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 Historic Preservation Commission Term 3 years
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 Frank F. Wagner HOME ADDRESS 1724 Muscatine Ave.
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? 35 + years Gender: Male a Female
OCCUPATION Contractor EMPLOYER Self - employed
PHONE NUMBER: HOME 319.321.7910 BUSINESS -jig.-121 7n1n
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I have been a life -long supporter of the many dimensions of Historic Preservation. Specifically I am a contractor who
specializes in the restoration and historically- appropriate repair and renovation of older homes. I have completed
ojects in such historically sensitive neighborhoods as St. Louis' Central West End, Georgetown, Alexandria VA not
Lo mention throughout Iowa City. I have a solid knowledge of historic materials and construction techiques.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I have a firm understanding of both the work and importance of the Historic Preservation Commision in its stated
mission to protect and enhance both structures and districts with historic, architectural and /or cultural value. I am
currently a member of the HPC
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FOR APPLYING)?
As a contractor who specializes in the restoration and historically- appropriate repair and renovatio'r -'of older homes
using appropriate materials and techniques, I believe I can advise the commision in this sR-qcific Via.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflic#Fei Interest '.,.
j
�.-
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 7 Yes F-1 No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? FYes PlfNo
(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.
aneral Application
June 2010 Page 2 of 8
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board /Commission /Committee Historic Preservation Commission
Name Frank F. Wagner
I r 1
�-..z.z4
M m tt
' '"y' ®'�
CITY OF IOWA CITY
Date 01/27/2012
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
Wagner Bros LLC
1724 Muscatine Ave., Iowa City Iowa 52240
NOTE: A new form
acquired in an addi
Applicant Signature r
Signature of parent/gua
Address 1724 Muscatine
pk$e fKythe above information changes or an ownership interest is
Gl/c
n (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.
aneral Application
June 2010 Page 3 of 8
City of �Gvva CRY
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.
Aovisory Board /Commission /Committee Name Historic Preservation Commission Term 2012 -2015
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 rdiar�
v _
NAME Esthe Ba' er- u - - HOME ADDRESS 1022 E_ Golleg tr ..t. lows-- City, A 52240
Is your home address (listed above) within the corporate limits of Iowa City? ✓0 Yes F-1 No
How long have you been a resident of Iowa City? nine years Gender: Male ❑ Female W]
OCCUPATION consultant EMPLOYER self - employed
PHONE NUMBER: HOME 319 - 354 -1483 BUSINESS
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I ve served two terms as a representative of the East College Historic District on the Hi�tpric Priervation
Commission. I have lived in /owned several historic homes of various eras over the past tw7oxdec s, aTfd ave an
appreciation for and understanding of the importance of preserving this important aspect �1?a-iorfiunityc' J istory.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? -T,
have served two terms on the Historic Preservation Commission and have assisted in grar riti for tffc)
Commission.
r�z
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)?
I have a deep appreciation for and understanding of the importance of preserving the buildings that are such an
important part of a community's heritage. I am committed to the preservation and conservation of historic structures,
while being mindful of the needs of today's home and business owners, contemporary usage, changes in regulations,
and the availability of new technology and materials that may be used for repairs and preservation of historic homes.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
None
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 7 Yes F] No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? . ❑Yes W]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
Name of City
Board /Commission /Committee Historic Preservation Commission
Name Esther M. Baker
S
I
CITY OF IOWA CITY
Date 01/30/2012
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a; cEty B.oardF:or. Commission from having an. interest ,in. a. city contract,: A.copy,of S$p lion: .362.5 is. attac
—• -•• -- •�-� ....�� y.,u, rvu� oNvuu�iwvii�eoen. Na�u�ci� vi, JJ aIU1IL.II I VUUI7.1UV1•JUly.UUIIIIIII„IUII
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
,A/,3 A J C
--
In-a I
a�
-M
o
_
r �^�
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additio (business.
Applicant Signature C
Signature of parent/guardian (Youth Advisory Commission only):
Address 1022 E. College Street, Iowa City, IA 52240
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 3 of 8
city of Iowa city I r 1
Advisory Board /Commission /Committee 4.;'III
Application Form -^�-�-
CITY OF IOWA CITY
THIa 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 Historic Preservation Commission Term 3 yrs /2012 -15
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 Ginalie Swaim HOME ADDRESS 1024 Woodl awn, Tnwn City, TA 59945
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? 38 yrs Gender: Male F] Female
OCCUPATION Histnri ral P�1; rnr EMPLOYER: State Historical society of Iow.
PHONE NUMBER: HOME 337 -9828 BUSINESS 335 -3932
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
Previous :terms on Historic Preservation-Commission. 28 years editing -Iowa history magazine
--ith stories on preservation and historic properties. Owner of home in historic district and
ive experienced design- review process by commission for our home. Prepared and presented
tours of historic neighborhoods. Repairing historic home after tornado of 2006.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
I understand the commission's mission and mandate and its role in approving applications
from property owners. The commission also educates the public;. encourages
stewardship, and upholds the Secretary of Interior's design standards.
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYIAG)?
I believe that I maintain an open mind to the interests and needs -of'.ti apro rty °ner
as well as those of the community, neighborhood, and future Iowa City �e�s .dents w1JQ yyill
value our historic neighborhoods. I recognize the economic value and qulity-of liming aspects
of prservation. I know there's a delicate balance between preservation'-F��nd c�liange —, ,
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflicf `ilnterest U �s
None.
c�
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑ Yes R No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? RYes FqNo
(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
w answer all the questions, Council may not consider your application.
General Application
January 2012 Page 2 of 8
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board /Commission /Committee Historic Preservation Commission
Name Ginalie Swaim
1 r i
T
CITY OF IOWA CITY
Date February 9, 201 e
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
c a
NOTE: A new form must be completed if the above information changes or are ownership interest is
acquired in an additional busjPess)
Applicant Signature
Signature of parent/guardian (YoutWVisi
Address 1024 Woodlawn, Iowa City IA 52245
Commission only):
Misrepresentations 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
January 2012 Page 3 of 8
25d
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
TELECOMMUNICATIONS COMMISSION
One Vacancy — Unexpired Term
Effective Upon Appointment - 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, February 15, 2012. 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.
1/11/2012
M 25e
3
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
TELECOMMUNICATIONS COMMISSION
Two Vacancies — Three -Year Terms
March 13, 2012 - March 13, 2015
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, February 15, 2012. 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.
1/26/2012
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: December 6, 2011; January 24, 2012
Application Deadline: Wednesday, 5:OOp.m., February 15, 2012
Council Appointment Date: February 21, 2012
After 03/05/2012 (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, 2012 — March 13, 2015
Term expires for Saul Mekies, Laura Bergus
Gender Balance Requirement: None
(M) Matthew Butler 1371
2602 Friendship St
(M) Nicholas Kilburg 0
915 Oakcrest St #19
(F) Laura Bergus 0
2231 California Ave
(Currently serving 1St three -year term)
0 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- 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: November 1, 2011; January 10, 2012
Application Deadline: Wednesday, 5:00 p.m., February 15, 2012
Council Appointment Date: February 21, 2012
After 01/30/2012 (3 mo from the announcement date) Council may appoint any qualified
applicant without regard to gender.
TELECOMMUNICATIONS COMMISSION
One vacancy - Unexpired Term
Effective upon appointment — March 13, 2014
Nolan Klouda resigned
Gender Balance Requirement: None
(M)
(M)
(F)
Matthew Butler 0
2602 Friendship St
Nicholas Kilburg 0
915 Oakcrest St #19
Laura Bergus 0 (Currently serving 1St three -year term)
2231 California Ave
El . Denotes applicant completed the Confidential page of the application.
City of Iowa City i r 1
Advisory Board /Commission /Committee`��
"nplication 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.
fV
Advisory Board /Commission /Committee Name Iowa City Telecommunications Commission, Tefa
Youth Advisory Commission (shall not be more than 18 years of age at the time of ap,plica#iog)
Name of Iowa City High School or high school equivalent:
Signature of parent/guardian: "mA
NAME Matthew Butler HOME ADDRESS 2602 Friendshin:St.
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? 15 years Gender: Male 7 Female F1
OCCUPATION Multimedia Consultant EMPLOYER University of Iowa
PHONE NUMBER: HOME 319 - 936 -1339 BUSINESS
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
For seven years, from 2005 -2011, 1 was the AV Specialist for the Iowa City Public Library responsible for the
( -to -day operations of the Library Channel. I was intimately familiar with the technical, logistical, and political
aopects of running a local access television channel. I often reported our activity to the ICTC. I am also a contributing
producer for PATV and have offered consultation to other local channels in Iowa City.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
As someone who recently had their salary come out of Iowa City's cable franchise fees, I became interested in the
workings of this board and how cable rights were negotiated in Iowa City. While I am not familiar with the inner
workings, I understand how the board relates to the city council and the public.
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)?
Operations level knowledge of local access television production. A balanced perspective concerning the needs of
the municipality, Iowa City citizens, local television channels, and businesses. A life -long committment to cable needs'
in Iowa City. Historical knowledge met with forward- looking goals.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑✓ Yes ❑ No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? F]Yes P/1No
(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
January 2012 Page 2 of 8
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board /Commission /Committee Iowa City Telecommunications Commission
Name Matthew Butler
�,MWPMNN5X=
CITY OF IOWA CITY
Date 01/26/2012
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
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additional business.
Applicant Signature
, v %
Signature of parent/guardian (Youth Advisory Commission only):
Address 2602 Friendship St.
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
January 2012 Page 3 of 8
City of Iowa City r i
Ott
Advisory Board /Commission /Committee #;;,�
VIII
+ ruylrmr
.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 FOR ANY VACANCY DURING THAT TIME.
Advisory Board /Commission /Committee Nam�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:
NAME �s K�� HOME ADDRESS�t��c2.�sT�.�`�
Is your home address (listed above) within the corporate limits of Iowa City? ffYes F1 No
How long have you been a resident of Iowa City? 5'IEgQ5 Gender: Male V Female
OCCUPATION TT`dx-jsE' EMPLOYER�tccC�
PHONE NUMBER: HOME S11 -9q1-3q2-1 6-60 BUSINESS 31 i. 3000Q- '� CP
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
—� +ZtcN p°lA �.K�- f 4^3Sa.,.,5 flaSE� uT� C.�r- �Bz�.►•q+��s,�S OF LOO 44rP1.vCArJte f'4CgS
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
zSec�s v,,ar�ss�s Z►' ,�Eb.o:Tfrrza ux>7{/ �Fttaa f�S� 1; V5 W�Va lzrip, ,we,
t �g� y C wcl cahk (; �D� 1
car�P+w4— S�ascxrA�'� o��L -rE'S, FictDS PUg�ie Ha-
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FOR- APPLYINIG ?
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
T 'Da 4-.-7- i �-T�v� -.3--7 mkvE Ar5 Ct.JPt =cr% bF v.a'r'W(Lfflf -r- ,'e— T� 12.1��.
F--F3, 34 u W=ur a*-, &'1-- .PL6.7 -V v0 -e1 ,tor c.RRRtrr'tZy �lRy.t° A.� C�sL� s..K'oI-7V�"L
-1-zI%. �.�-, eF �1—awo C_ /�a9 'Q c+ •V .�'w -M Q4U4 P.*k SQ ZL0
S Rvz�G �Il`
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ZYes 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
January 2012 Page 2 of 8
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City /" C__vHAI �
Board /Commission /Committee l�c�c�r- i►�u,� f
Name i- �.=G�sz. 1 • te='`30`�
10 ft
CITY OF IOWA CITY
Date f • 2Ce.12_
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
iJv ti)�
7:9
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additional business. �^
Applicant Sig
Signature of parent /guardian (Youth 6;Kvisory Commissio only):
Address `��� 0.+9<,Y45 rr`
0
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
January 2012 Page 3 of 8
City of Iowa City
Advisory Board /Commission /Committee 1k h
..m p
+ rywaor�
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 Telecommunications Term 2012-
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 Laura Bergus HOME ADDRESS 2231 California Ave.
Is your home address (listed above) within the corporate limits of Iowa City? n Yes F] No
How long have you been a resident of Iowa City? 31 years Gender: Male n Female
OCCUPATION Attorney EMPLOYER Hayek, Brown, Moreland & Smith, LLP
PHONE NUMBER: HOME (319) 541 -9677 BUSINESS (31g) 33m6n6
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
Prior term on the commission. Professional cable franchise oversight for 10 years (City of North Liberty). Good
)rking relationship with Mediacom.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
Current member, since 2009. -
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FOR APPLYING)?
Continue facilitating communication with cable franchisee and public regarding cable service. Provide guidance in
franchise oversight, enforcement, and negotiation.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
None.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? ❑✓ Yes R No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? nYes ❑✓ 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
January 2012 Page 2 of 8
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board /Commission /Committee Telecommunications
Name Laura Bergus
CITY OF IOWA CITY
Date 02/10/2012
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.
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additional business.
Applicant Signature_
JV
Signature of parent/guardian (Youth
Address 2231 California Ave.
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
January 2012 Page 3 of 8
M]
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
YOUTH ADVISORY COMMISSION
One Vacancy — 2 -Yr Term
January 1, 2012 - December 31, 2013
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, February 15, 2012. 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 Youth Advisory Commission should be directed to Marian Karr, City
Clerk at 356 -5041.
x
m
ZQOx
u u m u u
D
O O a y N
tD
cD =m
3 x
c CO C
O y
CD
A CL
O
c
3
O
c
�D
m
v
mDDcn
�0X
Nm-<
0 0 !C
m 0!C
ic
vy
0
z
rn
i:�:.
n
W
N
W
W
GJ
W
W
W
i)
W
C.)
N
w
N
m�
X
V N
x
x
m
x
x
Co
O
c
�D
m
v
mDDcn
�0X
Nm-<
0 0 !C
m 0!C
ic
vy
0
z
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: 2
Council Announcement Date: September 20, 2011; November 1, 2011; December 6,
2011; January 24, 2011
Application Deadline: Wednesday, 5:OOp.m., February 15, 2012
Council Appointment Date: February 21, 2012
(Recommendations to be made by Council liaison)
After 12/19/11 (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, 2012 — December 31, 2013
Term expires for Alexandra Tamerius
Gender Balance Requirement: 1 Female
(M) Edgar Thornton 0
631 Scott Park Dr
0 Denotes applicant completed the Confidential page of the application.
City of Iowa City r
Advisory Board /Commission /Committee' Tat-
Qnplication Form wiiiiii I.
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 Youth Advisory Commission Term
Youth Advisory Commission (shall not be more than 18 years of age at the time of a plic tion)
Name of Iowa City High School or hi school equ%i �alent: ' L S
Signature of parent/guardian: ,�G
NAME Edgar T. Thornton, IV HOME ADDRESS 631 Scott Park Drive, Iowa City, 52245
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? Since 2003 Gender`galel Ferrale�
OCCUPATION Sophomore at City High EMPLOYER
PHONE NUMBER: HOME 319 - 338 -5579 BUSINESS
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSIi•ION:
I an active member of Boy Scout Troop 250, and participate in many civic and cultural activities with the Troop,
ii .ding Scouting for Food. I am also an active member of Trinity Episcopal Church, participating with the youth
group and serving as an acolyte. At City High school I participate in the Band, Tennis and other activities. In these
roles I see the issues and needs of my friends and others, on both the east and west sides of town.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD?
The Youth Advisory Commission, unfortunately, has limited visibility within the general high school community. Most
people don't know what they do. I understand they make recommendations on a limited amount of funding directed
to young people, and consider /make recommendations on issues affecting youth.
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYING)?
As a Boy Scout I have received training in leadership - including public speaking and group decision making. I would
like to use these skills in helping the Commission become more visible and offering new and innovative suggestions
to address youth issues. As a mixed race, African- American/White, young man I am in a unique position to work
pro - actively @ to help us have a more important role and better image in the Iowa City community.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
None.
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? n✓ Yes F-] No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? [:]Yes W]No
(It has been Council policy not to permit an individual to serve on two Boards or Commissions at the same time.)
-
lisrepresentations, on this application will constitute just cause for removal of an appointee. If you fail
co answer all the
I questions, Council may not consider your a pp lication.
General Application
January 2012 Page 2 of 8
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board /Commission /Committee Youth Advisory Commission
Name Edgar T. Thornton, IV
� r
+ wir ®im�
CITY OF IOWA CITY
Date 01/25/2012
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
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additional business.
Applicant Sig natureV4X'/iG','
Signature of parent/guardian (Youth Advisory Commission only):
Address 631 Scott Park Drive, Iowa City, 52245
Misrepresentations 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
January 2012 Page 3 of 8
25
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, February 15, 2012. 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 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: 2
Council Announcement Date: October 26, 2010; December 7, 2010; January 10, 2011;
February 15, 2011; March 22, 2011; May 3, 2011; June 7, 2011; August 2, 2011; September
6, 2011; October 4, 2011; November 1, 2011; December 6, 2012; January 24, 2012
Application Deadline: Wednesday, 5:OOp.m., February 15, 2012
Council Appointment Date: February 21, 2012
(Recommendations to be made by Council liaison)
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: 1 Female
No applications as of Wednesday, 5:OOp.m., February 15, 2012
121 Denotes applicant completed the Confidential page of the application.