KNIGHTS OF COLUMBUS #12144 - REDACTED.PDF

SECTION 10
1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
CI Yes No {If yes, attach explanation.)
2. How many special event licenses have been issued to this location this year? KolIii-71:-.
(The number cannot exceed 12 events per year; exceptions under A.R.S. §4-203.02(D).)
3.1s the organization using the services of a promoter or other person to manage the event? ElYes JEI,No
(If yes, attach a copy of the agreement.)
4. List all people and organizations who will receive the proceeds. Account for 100% of the proceeds. The
organization applying must receive 25% of the gross revenues of the special event liquor sales. Attach an
additional page if necessary.
Name e-,t4 I Gi.tis.S bF (LLABU ,5 /vZ / 4‘) Percentage /CAD%
974:9 4IA „SuAl 4z_ 85-373
Address Street City State Zip
Name Percentage
Address Street City State Zip
5. Please read A.R.S. §4 -203.02 Special event license rules and R19-1-205 Reauirements 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 CONTAINERS
OR THE SPECIAL EVENT LICENSE IS STACKED WITH WINE /CRAFT DISTILLERY FESTIVAL LICENSE"
6. What type of security and control measures will you take to prevent violations of liquor laws at this event?
(List type and number of police/security personnel and type of fencing or control barriers, if applicable.)
Number of Police / Number of Security Personnel OFencing El Barriers
Explanation:
SECTION 11 Date(s) and Hours of Event. May not exceed 10 consecutive days.
See A.R.S. §4-244(15) and (17) for legal hours of service.
Event Start License End
Date Day of Week Time AM/FM\ Time A Mtr5
to
DAY 1: 9,J0 co
DAY 2:
DAY 3:
DAY 4:
DAY 5:
DAY 6:
DAY 7:
DAY 8:
DAY 9:
DAY 10:
10/17/14 Page 2 of 4
Individuals requiring ADA accommodations call (602)542-9027.

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.
N1'
EL.k7.-Ak sa-T-14
dAuw.
sej.o EPA/
10/17/14 Page 3 of 4
Individuals requiring ADA accommodations call (602)542-9027.