BENT BUT NOT BROKEN - REDACTED.PDF

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FOR DILC USE ONLY
Arizona Department of Liquor Licenses and Control aati Rotel
800 W Washington Sth Floor
Event time start/end:
Phoenix, AZ 85007-2934
www.aziiquor.gov aay ‘
(602) 542-5141
Licanse:
APPLICATION FOR SPECIAL EVENT
LICENSE
Fee= $25.00 per day for 1-10 days
A service fee of $25.00 will be charged for all (consecutive)
dishonored checks (A.R.S, § 44-6852)
IMPO TLINFOR ON: This docume
The Department of Liquor Licenses us} be fully ¢ €q ort will be rev
and Confrol must receive this application ten b
(10) business days prior to the event. If the
the Department? of Liquor Licenses and Control (see Section
15).
SECTION.1 Name of Organization: Lear Out Mor b 10K
ty
SECTION 2 Non-ProfitARS Tox Exempt Number;__«- #57 —~ Ss OP Hy
2
SECTION 3 The organization Is a: (check one
box.only)
ViCharitable L]rratemal
(must have regular membership and have been in existence for
C Religious Cicivie (Rotary, aver five (5) years)
College Scholarship) []Potttical Party, Ballot Measure
or Campaign Committee
SECTION 4 Wil this event be held on a currently licensed
premise and within the already approved premises? [Ves Kho
Name of Business
Ucense Number
Phone (include Area Cede)
SECTION 5 How is this special event going to conduct
318 for explanation (look in special event all dispensing, serving, ond selling of spirituous liquors? Please read R19.
planning guide) and check one of the following boxes,
Place license in non-use
[_IDispense ond serve all spirituous liquors under retailer's
license
Dispense ond serve alll spirituous liquors under
special event
plit premise between special event and retail location
(If not using retail license, submil a leer of agreement from the
event, If the special avent Is only using a porfion of agent/owner of the llcensed premise to suspend the Ilcense
Premise, agent/owner will need to suspend thal during the
SECTION 6 What Is the porilon of the premise.)
purpose of this event? WlOn-site
consumption [Clortsite (auction) [oth
SECTION 7 Location of the Event; Scarizona
Address of Location: 1901 N Alma School Road
Maricopa County AZ 85201
Steel City
SECTION.A will this be stacked with COUNTY Stato 1p
a wine festival/craft clistiller festival? Clves §ZINo
SECTION? Applicant must be a member of the
of the Organization named in Section 1. Qualifying organlzation and authorized by an Officer, Director
(Authorizing signature is required In Section or Chairperson
Horror 13.)
1. Applicant: VA Fier “Diane
Leds
First
Hiletelfe
2, Applicant's malling address: LL. Lf 2? MW 7 2? Greer
“ (%o ad Aol. Ak
Se BP BY
3. Ciy C7 State o
Applicant's home/cell phon Zip
lIcant! a
4. Applicant's emalll address:
7/22/2018
Page 1 of 4
Individuals requiing ADA accommodations call
(602)549.9027,
Received Time Oct, 9 2015 4:14PM No. 0979

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SECTION 10
1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
Ces L7ZNo (if yes, attach explanation.)
J j
a
2, How many special event licenses have been issued to this location this year?
(The number cannot excead 12 events per year; exceptions under A.R.S, §4-203.02(D).)
3, Is the organization using the services of a promoter or other person to manage the event?i@ives JA °
(If yes, attach a copy of thé agreem
4. List all people and organizations who will receive the proceeds. Account for 100% of the proceeds, The organization
applying must recelve 25% of the gross revenues of the special event liquor sales. Attach an additional page if necessary.
Searizona 9%
Name Percentage:
Adaress 1901 N Alma School Rd Maircopa County AZ 85204,
Clty State up
Bort But Not 25%
nome Percentage:
AL.
Addirass ALD NN. Ki Lestiedale Ps250
Street cily State Zip
5. Please read A.R.S. § 4-203,02 Special event license: rules and R19-1-205 Requirements for a Special Event License.
Note: ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY.
“NO ALCOHOLIC BEVERAGES SHALL LEAVE SPECIAL EVENT UNLESS THEY ARE IN AUCTION SEALED GONTAINERS OR THE
SPECIAL EV SEIS ST WITH W. CRAFT Y_FE LICENSE”
6, What type of security and control measures will you take to prevent violations of liquor laws at this event?
(st type and number of police/security personnel and type of fencing or control banters, If applicobfe.)
1 4-6
Number of Police Number of Security Personnel Fencing Vlpaniers
Explanation: Beer and wine garden to be fenced in on 3 sides with a baracade fencing on one side
for engrees egrees. Off duty Sheriff to monitor all incoming.and out going patrons. Security to ID
everyone entering. 21 and older on in the beer wine garden, No beverages in or out of the area.
SECTION 11 Date(s) and Hours of Event. May not exceed 10 consecutive days,
See ARS. § 4-244(15) and (17) for legal hours of service.
pay): 10-22-15 Thursday 6pm 12am
— .
pay2: 10-23-15 Friday 6pm 12am
pay3, 10-24-15 Saturday 6pm 12am
pay 4: 10-25-15 Sunday 6pm 12am
DAY 5:
DAY 6:
DAY 7:
DAY 8:
DAY 9:
DAY 10:
7/22/2018
Page 2 of 4
Individuals raquitina ANA aceammodations call (602)542-9027,
Received Time Oct. 9. 2015 4:14PM No. 0979

SECTION 12 License premises diagram. The licensed premises for your special event is the area in which you are authorized
to sell, dispense or serve alcoholic beverages under the provisions of your license. The following space is to be used to
prepare a diagram of your special event licensed premises. Please show dimensions, serving areas, fencing, barricades, or
other control measures and security position.
Heures
House 4*
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Individuals requiring ADA accommodations call (602)542-9027.

SECTION 13 To be completed only by an Officer, Director or Chairperson of the organization named in Section 1.
l, declare that | am an OFFICER, DIRECTOR, or CHAIRPERSON
(Print Full Name)
appointing the applicant listed in Section 9, to apply on behalf of the foregoing organization for a Special Event
Liquor License.
X
(Signature) Title/ Position Date Phone #
The foregoing instrument was acknowledged before me this
Day Month Year
State County of
My Commission Expires on:
Date Signature of Notary Public
SECTION 14 This section is ta,be completed only by the applicant named in Section 9.
YaCr 7 [lo 1VPS0 4 declare that | am the APPLICANT filing this application as
(Print Full Name)
listed in Section 9. | have read the application and the contents and all statements are true, correct and
( Vite. Do Loar Trombo GLYS
( by hor
(Signature) Title/ Positio Phone #
ds,
lp hy bev L095.
The was acknowledged before.me this iA} Zz
a
nae ante Day
State County of 3
OTARY PUBLIC
STATE OF ARIZO ij
[4 4)\ ae
My Commission Expires on: fy f) e Maricopa/Coun SN J\
Diite HELEN
Please contact the local governing board for additional application requirements and submission deadlines. Additional
licensing fees may also be required before approval may be granted. For more information, please contact your local
jurisdiction: http://www.azliquor.gov/assets/documents/homepage docs/spec event links.pdf.
SECTION 15 Local Governing Body Approval Section
F recommend DIAPPROVAL OJ DISAPPROVAL
(Government Official) (Title)
on behalf of , , ,
(City, Town, County) Signature Date Phone
FOR DEPARTMENT OF LIQUOR LICENSES AND CONTROL USE ONLY
CIAPPROVAL C1 DISAPPROVAL _ BY: DATE:
A.R.S. § 41-1030. Invalidity of rules not made according to this chapter: prohibited agency action; prohibited acts by state
employees; enforcement; notice
B. An agency shall not base a licensing decision in whole or in part on a licensing requirement or condition that is not
specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a
basis for imposing a licensing requirement or condition unless a rule is made pursuant to that general grant of authority that
specifically authorizes the requirement or condition.
D. THIS SECTION MAY BE ENFORCED IN A PRIVATE CIVIL ACTION AND RELIEF MAY BE AWARDED AGAINST THE STATE. THE
COURT MAY AWARD REASONABLE ATTORNEY FEES, DAMAGES AND ALL FEES ASSOCIATED WITH THE LICENSE APPLICATION TO A
PARTY THAT PREVAILS IN AN ACTION AGAINST THE STATE FOR A VIOLATION OF THIS SECTION.
E. A STATE EMPLOYEE MAY NOT INTENTIONALLY OR KNOWINGLY VIOLATE THIS SECTION. A VIOLATION OF THIS SECTION IS
CAUSE FOR DISCIPLINARY ACTION OR DISMISSAL PURSUANT TO THE AGENCY'S ADOPTED PERSONNEL POLICY.
F. THIS SECTION DOES NOT ABROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.01 OR 12-820.02.
7/22/2015 Page 4 of 4
Individuals requiring ADA accommodations call (602)542-9027.

SECTION 13 completed Officer, Director or Chairperson of the organization named in Section 1.
vai , Dey
{A V\ | \2e Seaclara that | am an OFRCER, DIRECTOR, or CHAIRPERSON
i, xl
d Fu@Name) é
appointing the applicant-fted in Section 9, to apply on behalf of the foregoing orga 1 Kea ae Event
Liquor License. . eel
DoW
addey Pounce.
a
Rn e
U(ganaue) j
° 2a
(/ C z is eh
Gf} / Sopplesap Ae Z
The foregoing instrument was wledged before me this ,
M 3 as
hor - Uaeicoen . Day 3327
Sate 2(AIY County of
UJ 3 me z
A Pa —
i = 3 z
My Commission Expireson: OL 22 { ZO] + ff
_. 3
Date euoZuy
SECTION 14 Thissection isto be completed only by the applicant named in Section 9.
declare that | am the APPLICANT filing this application as
(Print Ful Name)
fisted in Section 9. {| have tread the application and the contents and all datements are true, comect and
complete.
x _s —
‘We! Postion Date Phone #
{Sgratve)
The foregoing ingrument was acknowledged before me this en : vases
Day Month Year
Gate SC County f
My Commisson Expireson: —_—
Bate Sgnature of Notary Public
Please contact the local goveming board for additional application requirements and submisdon deadlines Additional
fcensng fees may also be required before approval may be granted. For more information, please contact your local
jurisdiction: bitp// ww a8 ziguor.g oviasetydocumentvyhomepage docsyspec event linkspdf.
SECTION 15 Local Goveming Body Approval Section
recommend CJAPPROVAL (1 DISAPPROVAL
i,
(Govemment Official) (Bie)
onbehalfof___ ~~ :
{City, Town, County) Sgnatee Date Phone
FOR DEPARTIMENTOF LIQUOR LIC ENSESAND CONTROL USF ONLY
CIAPPROVAL [J DISAPPROVAL _ BY: DATE:
ARS § 41-1030. Invalidity of mies not made according to this chapter: prohibited agency action: prohibited acts by sate
employees enforcement: notice
B. An shallnot base a licensng decison in whole orin part ona licengng requirement or candition that isnot
agency
authorized by statute, mle or date tribal gaming compact. A general grant of authority in gatute doesnot congitute a
specifically
bagsfor imposng a licensng requirement or condition unlessa rule ismade pursuant to that general grant of authonty that
specifically authorizes the requirement or condition.
D. THISSECTION MAY BE BNFORCED IN A PRIVATE CIVILACTION AND REEF MAY BE AWARDED AGAINST THE STATE THE
: COURT AWARD REASONABLE ATIORNEY FEES DAMAGESAND ALL FEES ASSOCIATED WITH THE LIC ENSE APPLICATION TO A
MAY
PARTY THAT PREVAILSIN AN ACTION AGAINST THE SIA TE FORA VIOLATION OF THISSEC TION.
— A STATE EMPLOYEE MAY NOTINTENTIONALLY OR KNOWINGLY VIOLATE THIS SECTION. A VIOLATION OF THISSECTION IS
CAUSE FOR DISCIPLINARY ACTION OR DISMISSAL PURSUANT TO THEAGENC YS ADOPTED PERSONNEL POLICY.
E THISSEC TION DOESNOT ASROGATE THE IMMUNITY PROVIDED BY SECTION 12-820.01 OR 12-820.02.