PERMANENT EXTENSION_REDACTED.PDF

Arizona Department of Liquor Licenses and Control
https://www.azliquor.gov ———_DULC USE ONLY

(602) 542-5141 Job fs
aera Date Accepted:
PERMANENT EXTENSION OF ic:

PREMISES/PATIO PERMIT l ticense i

NON-REFUNDABLE $50.00 FEE WILL APPLY

*OBTAIN APPROVAL FROM LOCAL GOVERNING BOARD BEFORE SUBMITTING TO THE DEPARTMENT OF LIQUOR*
**Notice: Allow 30-45 days to process permanent change of premises**

License#:; 06070539
Specific purpose for change: Assuming occupancy of the adjacent suite

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 State Zip Code
4. Mailing address: PO Box 2502 Chandler AZ 85244
Street Chy State Zip Code
5. Email Address: liquorlicense@azlic.com
6. Business Phone Number; 623-935-5810 Contact Phone Number:
7, Is extension of premises/patio complete? Cnwya yes [INo
if no, what is your estimated completion date?
8. Do you understand Arizona Liquor Laws and Regulations? Yes [] No
9. Does this extension bring your premises within 300 feet of a school? [1 Yes No
10. Have you received approved Liquor Law Training? Yes [] No

11. What security precautions will be taken to prevent liquor violations in the extended area?
Extended area will be under constant supervision by employees during periods of use.

FEB 8-3-2026

— MARICOPA COUNTY
CLERK BOARD OF SUPERVISORS

5/5/2025 Page | of 2 UC-GEN-EXT-PERM-OO1

Individuals requiring ADA accommodations please call (602)542-2999

IMPORTANT
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

Cobarrier 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 to a licensed premises. List specific reasons for exemption:

DApproval OI pisapproval by DLLC:

SIGNATURE

Declaration: ; ,
i, (Print Name) Jeffrey Craig Miller , declare under penalty of perjury that | am

authorized 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, correct and complete.

o” (77 Signature

GOVERNING BOARD

After completion, and 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.

0 Approval O1 Disapprovat

Authorized Signature Agency

DLLC USE ONLY

Investigation Recommendation: CJ Approval [J Disapproval by:

Director Signature required for Disapprovals:

5/5/2025 Page 2 of 2 LIC-GEN-EXT-PERM-001
Individuals requiring ADA accommodations please call (602}542-2999

Proposed Extended Area