HomeMy WebLinkAbout2014-07-15 Appointment11a
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
AIRPORT COMMISSION
One Vacancy — Four Year Term
March 1, 2014 - March 1, 2018
Duties: To exercise all the powers granted to cities and towns under Chapter 330 of the Code of
Iowa, except the power to sell said airport. To annually certify the amount of taxes within the limitations of
the Statutes of the State of Iowa to be levied for Airport purposes. All funds derived from taxation or
otherwise for airport purposes shall be under the full and absolute control of the Airport Commission,
deposited with the City Treasurer, and disbursed only on the written warrants or order of the Airport
Commission.
Iowa City- appointed members of boards and commissions must be eligible electors of the City of
Iowa City. The Airport Commission meets the second Thursday of each month at 5:45 p.m.
Applications must be received by 5:00 p.m., Wednesday, June 25, 2014. The City of Iowa City
encourages diversity in the appointment of citizens to boards and commissions. Persons interested in
being considered should contact the City Clerk at City Hall, 410 E. Washington Street. Application forms
are available from the Clerk's office upon request or on the City website at www.icgov.org.
Questions about the Iowa City Airport Commission should be directed to 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: 2
Females: 2
Council Announcement Date: November 12, 2013, January 7, 2014, February 18, 2014,
April 1, 2014, May 20, 2014
Application Deadline: Wednesday, 5:00 p.m., June 25, 2014
Council Appointment Date: July 15, 2014
After 02/10/2014 (3 mo from the announcement date) Council may appoint any qualified
applicant without regard to gender.
AIRPORT COMMISSION
One Vacancy - Four Year Term
March 1, 2014 - March 1, 2018
Term expires for Howard Horan
Gender Balance Requirement: 1 None
(M) David Davis El
1532 Dickenson Lane
(M) A. Jacob Odgaard I]
934 Estron St.
(M) Richard Bartlett O
228 Raven St.
ODenotes applicant completed the Confidential page of the application.
City of Iowa City j 1
AdvicnniW WY Y gym✓ '4Y✓ Y W Mu✓ W+W Y N `YW VW Y Y Y 4n✓ Wr Y WeY' 4 YI VsW' `.an' Y Ys ✓atom+ w� � �Ica-
%pplication Fora
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 Airport Commission Term 4 year
NAME David Davis HOME ADDRESS 1532 Dickenson Lane
Is your home address (listed above) within the corporate limits of Iowa City? 0 Yes [—] No
How long have you been a resident of Iowa City? 8 Years Gender: Male F✓ Female[]
OCCUPATION Hotel Manager EMPLOYER Kinseth Hospitality
PHONE NUMBER: HOME 319 -541 -9296 BUSINESS 319 - 351 -0731
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I have served on various boards through my career. I was an air traffic controller in the Navy.
N
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VVr1A1 IJ TUUKrKCJCiNI 1XNUVVLCL)Ur -Ut- I MR) AUVIJUKT OUAKU! - -1
►nly what is described in the Commission description. _m
CD
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYING)?
I will use common sense for any decisions that need to be made. I will be dependable, punctual, attentive, and
respectful to all, and will comply with all rules and regulations. I would like to be more involved in my community,
and an active leader.
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 ❑ No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? RYes ❑✓ 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 2014 Page 2 of 7
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Y�ir1- irar.y� 6o�.YfY!l iY�.�YVYW i'illy" A i" a7
BUSINESS LISTING
Name of City
Board /Commission /Committee Airport Commission
Name David Davis
r j
CITY OF IOWA CITY
Date 04/29/2014
Section 362.5.of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 7).
List all businesses in which you, or your spouse /domestic partner, have an ownership interest
(for example, sole proprietor, partner, 5% or more of corporation's stockholdings).
Please indicate if there are none.
BUSINESS NAME
BUSINESS ADDRESS
none
C-)-< i
ca s
M
�, cn
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additional business.
Applicant Signature
Address 1532 Dickenson Lane
Misrepresentations on this application will constitute just cause for removal of an appointee. If you fail
to answer all the questions, Council may not consider your application.
General Application
January 2014 Page 3 of 7
City of Iowa City _#I r 1
�� ®oa
Advisory Board /Commission /Committee 4 k k4a;;r4W " Y' ®•TR
Application 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.
Advisory Board /Commission /Committee Name Iowa City Airport Commission Term 4 (end of H's)
NAME A. Jacob Odgaard HOME ADDRESS 934 Estron St, Iowa City, IA 52246
Is your home address (listed above) within the corporate limits of Iowa City?
How long have you been a resident of Iowa City? 36 years
✓0 Yes ❑ No
Gender: Male ❑✓ Female
OCCUPATION Professor, Civil and Environmental Engrg. EMPLOYER University of Iowa
PHONE NUMBER: HOME 319 - 331 -0388
BUSINESS 319 - 335 -5213
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POWION:.c-
1. Civil Engineer (consulting with both the private sector and local, state, and government a ie
2. Educator (Professor at the UI for 36 years);
3. FAA Certified Flight Instructor for ten plus years;
4. Captain in the Civil Air Patrol (Cedar Rapids Composite Squadron); and
5. Member of the Iowa City Noon Rotary Club.
ea
/HAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? F"
1. Am familiar with the 2011 -15 Strategic Plan and the Commission's effort to implement it.
2. Have followed the Commission's role in (1) facilitating the upgrades of the airport infrastructure (terminal building,
hangars, maintenance hangar, runways, taxiways, ramp, etc); (2) promoting flight instruction and outreach to the
community; and (3) organizing fly -ins.
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FORAPPLYING)?
1. Fill the void created by Paul Hofineyer's death.
2. Help make the airport a significant Iowa City attraction, with upgraded flight instruction, fly -ins, and other
community activities consistent with the Strategic Plan, incl. making the airport a University of Iowa resource.
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 ❑ No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? FYes �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 2014 Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board /Commission /Committee Iowa City Airport Commission
Name A. Jacob Odgaard
� r
�!m;,�
CITY OF IOWA CITY
Date 05/10/2014
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 7).
List all businesses in which you, or your spouse /domestic partner, have an ownership interest
(for example, sole proprietor, partner, 5% or more of corporation's stockholdings).
Please indicate if there are none.
BUSINESS NAME
BUSINESS ADDRESS
None
c-a —
� a
F �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.
Address 934 Estron St, Iowa City"IA 52246
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 2014 Page 3 of 7
City of Iowa City r i
Advisory Board /Commission /Committee; ;' h
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 Airport Commission Term 4
NAME Richard Bartlett HOME ADDRESS 228 Raven Street, Iowa City, IA 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? 4yrs Gender: Male 0✓ FemaleEl
OCCUPATION Information Technology EMPLOYER Crystal Group
PHONE NUMBER: HOME 319 - 431 -2902
BUSINESS
EXPERIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I possess an admiration for flight. I come from a family of pilots and undestand the complexities an airport system
has on a city.
WHAT IS YOUR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? c_;
I have a very good understanding of the board and its' goals. -= f
7.
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,
ru
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD (REASON FOR APPLYING)?
As someone with flight experience, I feel I am able to bring a passion and knowledge of the industry. Also, being
someone of morals and ethics, I have a "Let's get the job done" mentality that would benefit the board.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
N/A
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? R,/Yes F-1 No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? FYes F,/ —1
(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
May 2014 Page 2 of 7
BOARD, COMMISSION AND COMMITTEES
BUSINESS LISTING
Name of City
Board /Commission /Committee Airport Commission
Name Richard Bartlett
f
CITY OF IOWA CITY
Date 06/16/2014
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 7).
List all businesses in which you, or your spouse /domestic partner, have an ownership interest
(for example, sole proprietor, partner, 5% or more of corporation's stockholdings).
Please indicate if there are none.
BUSINESS NAME
BUSINESS ADDRESS
ED -
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additional business. �
Applicant Signature
Address 228 Raven Street, Iowa City, IA 52245
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
May 2014 Page 3 of 7
Airport Commission
April 24, 2014
Page 3
Airport Zoning Commission
ATTENDANCE RECORD
2014
Key:
X = Present
X/E = Present for Part of Meeting
O = Absent
O/E = Absent/Excused
NM = Not a Member at this time
TERM
C)
C)
NAME
EXP.
O��
4
cri
N
John Etheredge
12/31114
X
O/
X
E
Christine Douglas
12/31/15
X
X
I X
Matthew Wolford
12/31/17
X
X
X
Terry Dahms
03101/16
X
X
X
Elaine Hayes
O/
X
E
Key:
X = Present
X/E = Present for Part of Meeting
O = Absent
O/E = Absent/Excused
NM = Not a Member at this time
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, 2012 - December 31, 2016
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, June 25, 2014. 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.
I 1b
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: December 6, 2011; January 24, 2012; March 6, 2012;
April 3, 2012, May 1, 2012; June 5, 2012; July 31, 2012; September 4, 2012; October
23, 2012; December 4, 2012; January 8, 2013; February 19, 2013; March 19, 2013; April
23, 2013; June 4, 2013; July 23, 2013; August 20, 2013; September 17, 2013,
November 12, 2013, December 17, 2013, February 18, 2014, April 1, 2014, May 20,
2014
Application Deadline: Wednesday, 5:OOp.m., June 25, 2014
Council Appointment Date: July 15, 2014
After 03/05/2012 (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, 2012 - December 31, 2016
New Full Term
Gender Balance Requirement: None
No Applications as of Wednesday, 5:OOp.m., June 25, 2014
El Denotes applicant completed the Confidential page of the application.
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
AIRPORT ZONING BOARD OF ADJUSTMENT
One vacancy — Five -Year Term
January 1, 2014 - December 31, 2018
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, June 25, 2014. 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.
71c
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: August 20, 2013; September 17, 2013, November 12, 2013,
December 17, 2013, February 18, 2014, April 1, 2014, May 20, 2014
Application Deadline: Wednesday, 5:OOp.m., June 25, 2014
Council Appointment Date: July 15, 2014
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
Previously advertised; term expired for Dennis Keitel
January 1, 2014 — December 31, 2018
Gender Balance Requirement: None
No Applications as of Wednesday, 5:OOp.m., June 25, 2014
❑x Denotes applicant completed the Confidential page of the application.
I I ,,\
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING BOARD:
BOARD OF APPEALS
One Vacancy — Five -Year Term
January 1, 2014 - December 31, 2018
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, June 25, 2014. 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: 3
Females:
Council Announcement Date: October 1, 2013, November 12, 2013, December 17,
2013, February 18, 2014, April 1, 2014, May 20, 2014
Application Deadline: Wednesday, 5:00 p.m., June 25, 2014
Council Appointment Date: July 15, 2014
After 01/27/2014 (3 mo from the announcement date) Council may appoint any qualified
applicant without regard to gender.
BOARD OF APPEALS
Gender Balance Requirement: none
One Vacancy — to fill a five year term
January 1, 2014 - December 31, 2018
Term expires for Chad Campion
No Applications as of Wednesday, 5:OOp.m., June 25, 2014
0 Denotes applicant completed the Confidential page of the application.
07 -15 -14
11e
NOTICE
THE CITY COUNCIL OF IOWA CITY IS CONSIDERING APPOINTMENT TO THE FOLLOWING COMMISSION:
HISTORIC PRESERVATION COMMISSION
One Vacancy — Three Year Term
March 29, 2013 - March 29, 2016
(1) Jefferson St 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, June 25, 2014. 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 Bob Miklo, Sr
Planner at 356 -5240.
7/9/2014
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: 5
Council Announcement Date: February 5, 2013; March 19, 2013; April 23, 2013; June
4, 2013; July 23, 2013; August 20, 2013, September 17, 2013, November 12, 2013,
December 17, 2013, February 18, 2014, April 1, 2014, May 20, 2014
Application Deadline: Wednesday, 5:00 p.m.; June 25, 2014
Council Appointment Date: July 15, 2014
After 05/06/2013 (3 mo from the announcement date) Council may appoint any qualified
applicant without regard to gender.
HISTORIC PRESERVATION COMMISSION
One Vacancy - Three Year Term
March 29, 2013 — March 29, 2016
Gender Balance Requirement: None
Jefferson St District Representative
(New District)
(M) Richard Bartlett 0
228 Raven St.
(does not live in district)
0 Denotes applicant completed the Confidential page of the application.
City of Iowa City —4 1, r 1
���I -a&
Advisory Board /Commission /Committee k 2%
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
NAME Richard Bartlett HOME ADDRESS 228 Raven Street, Iowa City, IA 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? 4yrs Gender: Male 7 FemaleEl
OCCUPATION Information Technology EMPLOYER Crystal Group
PHONE NUMBER: HOME 319 - 431 -2902 BUSINESS
FYPFRIENCE AND /OR ACTIVITIES WHICH YOU FEEL QUALIFY YOU FOR THIS POSITION:
I have been a commission member for the Hanover, NH Conservation Commission and have volunteered for Historic)
Preservation Renovation projects in Iowa, Georgia, Alabama, Louisiana, Vermont, and New Hampshire.
WHAT IS VntJR PRESENT KNOWLEDGE OF THIS ADVISORY BOARD? Z
ztt have a very good understanding of the board and its' goals. >Z
C-)
1 6
WHAT CONTRIBUTIONS CAN YOU MAKE TO THIS ADVISORY BOARD REASON FOR APPLYING)?
Preserving our past dictates our present and future. It may seem somewhat cliche' but simply put, I care about our
past and want to preserve our heritage.
LIST POTENTIAL CONFLICTS OF INTEREST: See page 1 for information regarding Conflict of Interest
N/A
IF YOU ARE NOT SELECTED, DO YOU WANT TO BE NOTIFIED? 0✓ Yes "No
DO YOU CURRENTLY SERVE ON ANOTHER IOWA CITY BOARD OR COMMISSION? F]Yes F,71No
(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
May 2014 Page 2 of 7
1 � i
BOARD, COMMISSION AND COMMITTEES,,"1 °�
BUSINESS LISTING,,._
CITY OF IOWA CITY
Name of City
Board /Commission /Committee Historic Preservation Commission Date 06/16/2014
Name Richard Bartlett
Section 362.5 of the Code of Iowa generally prohibits, with certain important exceptions, a member of
a city Board or Commission from having an interest in a city contract. A copy of Section 362.5 is attached
(see page 7).
List all businesses in which you, or your spouse /domestic partner, have an ownership interest
(for example, sole proprietor, partner, 5% or more of corporation's stockholdings).
Please indicate if there are none.
BUSINESS NAME
BUSINESS ADDRESS
C�
4 i
NOTE: A new form must be completed if the above information changes or an ownership interest is
acquired in an additional business. ,,
Applicant Signature.
Address 228 Raven Street, Iowa City, IA 52245
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
May 2014 Page 3 of 7
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