ST. KATHERINE GREEK ORTHODOX CHURCH_REDACTED.PDF

DLLC USE ONLY

SPECIAL EVENT LICENSE Job #:

APPLICATION FEE $25.00 PER DAY

Date Accepted:

Arizona Dept. of Liquor Licenses and Control CSR:

800 W. Washington St. 5" Floor Phoenix, AZ 85007
(602) $42-5141
Type or Print with Black Ink
1-10 days consecutive days only, Cash, Checks or Money Orders Only
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.
Evangelia Archuleta

]. Applicant:
2. Applicant's mailing addres

City

Stole:
3. Applicants home/cell phoge; Applicant's business phone: 480-390-4230

4, Applicant's email address: __
. St.Katherine Greek Orthodox
SECTION 2 Name of Non-Profit Organization, Candidate or Political Party/Gov.:

94-2876533 Church

SECTION 3 Non-Profil/IRS Tax Exernpt Number:

01524110
SECTION 4 Arizona Corporation Commission File #: If out of State please specify:

St. erine Communit ter

SECTION 5 Event Location Name: i aby Car
2716 N Dobson Rd Chandler AZ 85224

SECTION 6 Event Address: — ii wi

SECTION 7 Dates and Hours of Event. Days must be consecutive but may not exceed 10 consecutive days.

“SEPARATE APPLICATION FOR EACH “NON-CONSECUTIVE” DAY**

Event Start License End
Days Date Day of Week Time AM/PM Time AM/PM

ayrere ce 29, 2022 Saturday iam 11:59pm

DAY 2:

DAY 3:

DAY 4:

DAY 5:

DAY 6;

DAY 7:

DAY 8: = EE er

DAY 9: = = —

DAY10: nis

7/21$2022 Page 1 of 3
Individuals requiring ADA accommodations please call (602) 542-2999

SECTION 6 Whail type of security and control measures will you take to prevent violations of liquor laws at this event?
(List ype and number of police/securlly persornme! and type of fencing or control barrlets, if applicable.)

2
Number of Police ______ Number of Security Personnel [Fencing Carriers
buh We will hire two deputies in addition to self-policing the event. We will hire two licensed
Explanation: _ —
and bonded bartenders. This event is open to the public; we do not expect more than 400

attendees at a given time to order food and beverages (non and alchohilc) to enjoy indoors.

Parking is onsite on the east and west of the campus with overflow at 2828 W Comstock Dr.

SECTION 7 Will this event be held on a curently licensed premises and within the already approved premises?

Clyves[¥]No if yes, Local Governing Body signature is not required,

Name of Business license Number Phone (include Area Code)

SECTION 8 How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors? Please read
R-19-318 for explaination and check one of the following boxes.

(riace ficense in non-use

Cobispense and serve all spintuous liquors under retailer's license
[Mbisnense and serve all spirituous liquors uncer special event
Cl pit premise between special event and retail location

SECTION 9 What is ihe purpose of this event?

[Von-site consumption Cortsite {auction/wine/distilled spirits pull) [Both

SECTION 10
1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
Clves#INo tf yes, attach explanation.
1

2. How many special event days have been issued to this organization during the calendar year?
3. Is the Organization using the services of a Licensed Contractor?

Dyes]No If yes, please provide the Name of ihe Licensed Contractor:

4. \s the organization using the services of a series 6, 7, 11, or 12 licensee to manage the sale or service of alcohol?

Clves[¥]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%.
St.Katherine Greek Orthodox Church {00%
Name: Percentage:
2716 N Dobson Rd Chandler, AZ 85224
Address: {0 : _ a ,
i Street chy State Zip
Name: Percentage:
Address: -
Sheet Clty State Zip
7/21 {2022 Page 2 of 3

Individuals requiing ADA accommedations please call (602}542-2999

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 11 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 creas, fencing, barricades, or other control
measures and security position.

if the special event will be held at a location without a permanent liquor license or if the event will be on any porlion of a locallon
that is not covered by the existing liquor license, this application must be approved by the local government before submission
to the Department of Liquor Licenses and Control, 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.

Declaration:

|, (Print Name} Evangelia Archuleta . 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 stalements made on this application to be true, correct and complete.

THA =

aL

Dale Received:

1, _— recommend CIAPPROVAL [I DISAPPROVAL
(Government Official) (Title)

On behalf of

{Cily, Town, County) - Signature

DIAPPROVAL FI DISAPPROVAL BY:

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 noi specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute
does not constitute a basis for imposing o 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 ray 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 net abrogate the immunity provided by section |2-820,01 or 12-820.02,

7/21/2022 Page 3 of 3
Individuals requiring ADA accormmmadalions please Call (602)542-2999

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