WEST VALLEY TRAIL ALLIANCE_REDACTED.PDF
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DLLC USE ONLY Job #: Arizona Department Liquor License and Control 800 W Washington St. 5! Floor Date Accepted: Phoenix, AZ 85007-2934 Cok: azliquor.gov . 602-542-5141 license #: SPECIAL EVENT LICENSE APPLICATION FEE $25.00 PER DAY A service fee of $25.00 will be charged for all dishonored checks (A.R.S § 44-6852 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. 1. Applicant: Brian Murphy 2. Applicant's mailing address! City State Zip 3. Applicants home/cell phone 4. Applicant's email address: SECTION 2 Name of Non-Profit Organization, Candidate or Political Party/Gov.: West Valley Trail Alliance SECTION 3 Non-Profit/IRS Tax Exempt Number: 47-4882625 SECTION 4 Event Location: White Tank Mountain Regional Park 20304 W. White Tank Mountain Rd Waddell, AZ 85355 SECTION 5 Dates and Hours of Event. Days must be consecutive but may not exceed 10 consecutive days. See A.R.S. § 4-244(15) and (17) for legal hours of service. **SEPARATE APPLICATION FOR EACH “NON-CONSECUTIVE” DAY** Event Start License End Days pale Day of Week Time AM/PM Time AM/PM DAY 1: 8/19/2022 Friday 7:00PM 11:59PM DAY 2: DAY 3: DAY 4: DAY 5: DAY 6: DAY 7: DAY 8: DAY 9: DAY10: 4/9/2021 Page 1 of 3 Individuals requiring ADA accommodations please call (602)542-9027 SECTION 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 1 Number of Security Personnel [Fencing Carriers ID checks and wristbands to those 21 years and older. Security personnel will remain Explanation: at the entrance/exit of the fenced beer garden for the duration of the event to ensure no alcohol leaves the designated beer garden. No food/perishables will be served.--Canned beer only. SECTION 7 Will this event be held on a currently licensed premises and within the already approved premises? Dyes 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 explanation and check one of the following boxes. (Place license in non-use Lbispense and serve alll spirituous liquors under retailer's license M1bispense and serve all spirituous liquors under special event Csplit premise between special event and retail location SECTION 2 What is the purpose of this event? [On-site consumption L1Off-site (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? Dyes ZINo If yes, attach explanation. 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? Aravaipa Running LLC Yes CI No ff yes, please provide the Name of the Licensed Contractor: 4. Is the organization using the services of a series 6, 7, 11, or 12 licensee to manage the sale or service of alcohol? DO Yes M1 No if yes, please provide the Name of Licensee: License #: 5. The applying non-profit organization must receive 25% of the gross revenues of the total liquor sales. List the names of the individuals or organizations who will receive the rest of the proceeds, MUST EQUAL 100%. West Valley Trail Alliance percentage: 9/0 Name: Address 14295 W Roanoke Ave Goodyear, AZ 85395 Name: Aravaipa Running “ Percen tage: 25% mp Address: 2401 S. 24th St. Phoenix, AZ 85034 4/9/2021 Page 2 of 3 Individuals requiring ADA accommodations please call (602)542-9027 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 areas, fencing, barricades, or other control measures and security position. TACH DIAGRAM Ifthe 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 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. SIGNATURE 1, (Print Full Name) Brian Murphy hereby swear under penalty of perjury and in compliance with A.R.S. § 4-210(A)(2) and (3) that | have read and understand the foregoing and verify that the information and statements that | have made herein are true and correct to the best of my knowledge. Applicant Signature: Pee GOVERNING BOARD Date Received: recommend CIAPPROVAL [1 DISAPPROVAL (Government Official) (Title) On behalf of (City, Town, County) Signature DLLC USE ONLY CAppROVAL C1 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 not specifically authorized by statute, rule or state tribal gaming compact. A general grant of authority in statute does not constitute a basis for imposing a 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 may 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 not abrogate the immunity provided by section 12-820.01 or 12-820.02. 4/9/2021 Page 3 of 3 Individuals requiring ADA accommodations please call (602)542-9027 : VERTIGO NIGHT RUNS & RIDES SITE MAP Kx - Beer Garden tet 20° e200 Téeet -/ Mesh Cert evens Sr cackling of ( Wey Py ant Of */TD Che lk