TEMPORARY EXTENSION OF PREMISE_REDACTED.PDF
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APMENPMENT Arizona Department of Liquor Licenses and Control https://www.azliquor.gov (602) 542-5141 KE DLLC USE ONLY TEMPORARY EXTENSION OF Date Accepted: PREMISES /PATIO PERMIT a License #: A NON-REFUNDABLE $100 FEE WILL APPLY “OBTAIN APPROVAL FROM LOCAL GOVERNING BOARD BEFORE SUBMITTING TO THE DEPARTMENT OF LIQUOR* APPLICATION MUST BE SUBMITTED TO THE DEPARTMENT OF LIQUOR 30 DAYS PRIOR TO FIRST SCHEDULED DATE License#: 06070539 1. Agent Name: Miller Jeffrey Craig Last First Middle 2. Business Name: _Lucie's Sage & Sand 3, Business Location Address: 13831 W.Glendale/Ave. Glendale AZ — 85307 Street City Zip Code 4. Business Phone Number: 623-935-5810 Contact Phone Number: 5. walteg acres: City State ZipCode 7. Specific purpose for change: 2026 Luke Air Show Days 8a. Do you understand Arizona Liquor Laws and Regulations? Lhes Dono b. Does this extension bring your premises within 300 feet of a school? L_Nes Cho Dates of the temporary extension - Must not exceed 6 months Date Day of the Week Start Time End Time 03/21/2026 Saturday 9:00 AM 6:00 PM 03/22/2026 Sunday 9:00 AM 6:00 PM RECEIVED ~ FEB 85-2026 MARICOPA COUNTY UPERVISORS Must provide written notice to the Department of Liquor of any modification 10 days prior to change/addition to scheduled Temporary Extension. 5/5/2025 Page | of 2 LIC-GEN-EXT-TEMP-001 Individuals requiring ADA accommodations please call (602)542-2999 Arizona Department of Liquor Licenses and Control https://www.azliquor.gov (602) aera _ DLLC USE ONLY TEMPORARY EXTENSION OF Dat Accaped PREMISES /PATIO PERMIT A License #: A NON-REFUNDABLE $100 FEE WILL APPLY “OBTAIN APPROVAL FROM LOCAL GOVERNING BOARD BEFORE SUBMITTING TO THE DEPARTMENT OF LIQUOR* APPLICATION MUST BE SUBMITTED TO THE DEPARTMENT OF LIQUOR 30 DAYS PRIOR TO FIRST SCHEDULED DATE License#t: 06070539 1. Agent Name: Miller Jeffrey Craig last First Middle 2. Business Name: _Lucie's Sage & Sand 3, Business Location Address:__ 13831 W(Glendlale Ave. Glendale AZ 85307 Street City Zip Code 4. Business Phone Number: 623-935-5810 Contact Phone Number: 5. Mailing address: Zip Code 6. Email Address: 7. Specific purpose for change: 2026 Luke Air Show Days 8a. Do you understand Arizona Liquor Laws and Regulations? hes wo b. Does this extension bring your premises within 300 feet of a school? Lhes [Ao Dates of the temporary extension - Must not exceed 6 months Date Day of the Week Start Time End Time 03/21/2026 Saturday 9:00 AM 6:00 PM 03/22/2026 Sunday 9:00 AM 6:00 PM FEB 0 3.2026 ~ MARICOPA COUNTY CLERK BOARD OF SUPERVISORS _ Must provide written notice to the Department of Liquor of any modification 10 days prior to change/addition to scheduled Temporary Extension. 5/5/2025 Page | of 2 LIC-GEN-EXT-TEMP-001 Individuals requiring ADA accommodations please call (602)542-2999 IMPORTANT- REQUIRED ATTACHEMENTS 1, MUST SUBMIT A SECURITY PLAN and identify security measures in order to: . Provide for the safety of the patrons. . Ensure no one under legal drinking age purchases, possesses, or consume alcohol. ° Prevent unauthorized removal of alcohol from the extended premises. ° Prevent unauthorized carrying of alcohol onto the extended premises. 2. MUST ATTACH A DIAGRAM, clearly depicting your licensed premises along with the new extended area, if the extended area is not outlined and marked “extension” we cannot accept the application. BARRIER O Barrier Exemption: an exception to the requirement of barriers surrounding a patio/outdoor serving area may be requested, Barrier exemptions are granted based on public safety, pedestrian traffic, and other factors unique toa licensed premises. List specific reasons for exemption: oO Approval [CJ Disapproval by DLLC: SIGNATURE Declaration: |, (Print Name) __ Jeffrey Craig Miller : , declare under penalty of perjury that f am authorized by the licensee to submit this application. | have read the contents of this application and to the best of my knowledge believe all statements made on this application to be true, we and woe Signature tthe Gag GOVERNING BOARD After completion, at least 60 days BEFORE submitting to the Department of Liquor, please take this application to your local Board of Supervisors, City Council or Designate for their recommendation. This recommendation is not binding on the Department of Liquor. C1 Approval D Disapproval Authorized Signature Title Agency DLLC USE ONLY Investigations: Oo Approval | Disapproval by: Director Signature required for Disapprovals: 5/5/2025 Page 2 of 2 UC-~GEN-EXT-TEMP-001 individuals requiring ADA accommodations please call (602}542-2999 Security Plan 06070539 Lucie’s Sage & Sand 13831 W. Glendale Ave. Glendale AZ 85307 * Extended area will be surrounded by temporary fencing e ID Scanners will be utilized by staff at entrances, exits and bar locations ¢ Lucie’s Sage & Sand staff will be roaming the event Existing Licensed Premises oe