THE BARN HOUSE COMMUNITY_REDACTED.PDF
Extracted text (via ocr_local)
7845 characters
CSR: Amount: DLLC USE ONLY Job #: SPECIAL EVENT LICENSE — APPLICATION FEE $25.00 PER DAY ‘ CSR: Arizona Department of Liquor Licenses and Control > - pA, 800 W. Washington St. 5" Floor Phoenix, AZ 85007 license :*; — (602) 542-5141 Application MUST be submitted to the Department of Liquor 10 days prior to the event. SECTION 1 Applicant must be a member of a qualifying nonprofit organization, political party, or Government entity and authorized by an Officer, Director, or Chairperson of the Organization. Cassidy Porter 1 - . . - First Middle Street City State Zip 602-318-5537 1. Applicant: (Must be an Officer/Member of the Noi 2. Applicant's mailing address: 3. Applicants home/cell phone: Applicant's business phone: 4. Applicants emi aces: Al Lucky Clover Barn House Benefit The Barn House Community 5. Special Event Name: 6. Name of Non-Profit Organization, Candidate or Political Party/Gov.: 86-2403073 7. Non-Profit/IRS Tax Exempt Number: 8. Arizona Corporation Commission File #: 23181284 If out of State please specify: (Attach letter of good standing) 9. Event Location Name: The Barn House 10. Event Address: 1624 W. Banff Ln. Peoria, AZ 85381 Dates and Hours of Event - Days must be consecutive and may not exceed 10 consecutive days. **SEPARATE APPLICATION FOR EACH “NON-CONSECUTIVE” DAY** Days Date Day of Week Pay eee DAY 1: 03/15/2025 Saturday 4pm 10pm DAY 2: DAY 3: DAY 4: DAY 5: E i iz D DAY 6: REC DAY 7: JAN 4-3-2025 DAY 8: MARICOPA COUNTY DAY 9: CLERK BOARD_OF SUPERVISORS DAY10: 2/6/2023 Page 1 of 3 Individuals requiring ADA accommodations please call (602)542-2999 SECTION 2 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.) 1- RVA Security Number of Police © Number of Security Personnel MFencing ClBarriers Must explain security measures: We will be using volunteers and board members to check ids. We will have fencing all the way around the event. ‘The event will be 21 oF older ONLY and everyone will be asked for ID upon entry. We will also be using wristbands. We will have a special area where liquor vill be dispensed using a licensed bar tending company with 2 of our volunteers at the bar area as well. SECTION 3 What is the purpose of this event? [on-site consumption [of-site (auction/wine/distilled spirits pull) Cboth How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors? Check one of the following boxes. (R-19-318) A) Special Event being held on an unlicensed premises will require approval and signature by the Local Governing Body on page 3. (If checked move to section 4) B) CL] Will this event be held on a currently licensed premises and within the already approved and licensed area? (Must attach a letter from the licensed premises with an explanation of the option checked below) Name of Business license Number Phone (Include Area Code) [Place license in non-use - Special Event Licensee selling all alcohol without retailer involvement Must attach letter from the location suspending license for duration of special event L1Dispense and serve alll spirituous liquors under retailer's license — Business operates normally, minimum of 25% of gross revenue from alcohol sales is donated to licensee Libispense and serve alll spirituous liquors under special event - The special event licensee is in charge of selling alcohol that was purchased or donated by the special event licensee. The retailers existing alcohol inventory must be separated from any alcohol used during the special event. Must attach letter from the location suspending license for duration of special event Lisplit premise between special event and retail location - Both the special event licensee and the retailer will conduct sales of alcohol. (These sales will be done in separate areas. If alcohol is donated or purchased by the special event licensee it must be in a separate area than the alcohol that is dispensed by the licensed retailer.) Lot sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer will still be permitted to conduct all normal sale and service of alcohol. SECTION 4 1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years? (1 Yes [7] No If yes, attach letter of explanation. 2. How many special event days have been issued to this organization during the calendar year? 0 3. Is the Organization using the services of a Special Event Contractor? (A licensee can utilize the services of a special event contractor who may purchase and sell alcohol on behalf of the licensee. If no special event contractor is listed, the licensee is responsible for the sales and service of alcohol. } Yes LINo If yes, please provide the Name of the Special Event Contractor: Whitney Wingfield - 4, ls the organization using the services of a series 6, 7, 11, or 12 licensee to manage the sale or service of alcohol? (Licensees who hold a series 6, 7, 11, or 12 license are automatically qualified to be the special event contractor) (Yes No if yes, please provide the Name of Licensee: License #: 5. List the name of the Individual or Organization that will receive revenues, MUST EQUAL 100 PERCENT. Attach additional sheet if necessary. 2/6/2023 Page 2 of 3 Individuals requiring ADA accommodations please call (602)542-2999 Name: The Barn House Community Percentage: 100 Address: 7624 W. Banif Ln. Peoria, AZ 85381 Street City State Zip Name: Percentage: Address: Street Cily State Zip Please read A.R.S. § 4-203.02 Special event license; rules and R19-1-205 Requirements for a Special Event License. ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY. SECTION. 5 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. Please attach a diagram of your special event licensed premises. Please show dimensions, serving areas, fencing, barricades, or other control measures and security position. ==> ATTACH DIAGRAM If the special event will be held at a location without a permanent liquor license or If the event will be on any portion of a location that is not covered by the existing liquor license, this application must be approved by the local governing body before submitting to the Department of Liquor Licenses and Control. Please contact the local governing board for additional information. APPLICANT SIGNATURE Declaration: |, (Print Name) Cassidy Porter 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. i, Af Y [“ Signatgfe 7 LOCAL GOVERNING BODY Date Received: \, recommend [LIAPPROVAL [1 DISAPPROVAL (Government Official) (Title) On behalf of (City, Town, County) Signature The local governing body (city, town or municipality where the fair/festival will take place) may require additional applications to be completed and submitted. Please check with local government as fo how far in advance they require these applications to be submitted. Additional licensing fees may also be required before approval may be granted. AZDLLC USE ONLY CIAPPROVAL C1 DISAPPROVAL BY: 2/6/2023 Page 3 of 3 Individuals requiring ADA accommodations please call (602)542-2999 ——— en ©2025 Airbus, Map data ©2025 Google 20 ft \) encvranewe https://www.google.com/maps/@33.6195116,-11 2.22328, 151m/data=!3m1!1e3?entry=ttu&g_ep=EgoyMDI1 MDEwMi4wIKXMDSoASAFQAW%3D%3D 113, 7 eA C2E Whole area