WISCONSIN CLUB OF SUN CITY_REDACTED.PDF

DLLC USE ONLY

Job #:
Arizona Department Liquor License and Control
800 W Washington St. 5!» Floor Date Accepted:
Phoenix, AZ 85007-2934
CSR:
azliquor.gov
602-542-5141 SCE e

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: Daryl Lund
City State Zip
3. Applicants home/cell phone: Applicant's business phone: hone

4. Applicant's email address

Wisconsin Club of Sun City

SECTION 2 Name of Non-Profit Organization, Candidate or Political Party/Gov.:

SECTION 3 Non-Profit/IRS Tax Exempt Number: 61-1849230
SECTION 4 Event Location: SUN Bowl 10220 N 107th Ave Sun City AZ 85351

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
Time AM/PM Time AM/PM

DAY 1: 03/10/2022 Thursday 10:00AM 3:00PM

Days Date Day of Week

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.)

1 (LES) 2

Number of Security Personnel LoFencing [Barriers
We will hire one Law Enforcement Specialist (see attached confirmation)

Number of Police

Explanation:

and have 2 members of the Sun City Posse present the entire time of the event.

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

OYes 1 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

Didispense and serve alll spirituous liquors under retailer's license
[Dispense and serve all spirituous liquors under special event
Lisplit premise between special event and retail location

SECTION 2 What is the purpose of this event?

[On-site consumption [Off-site (auction/wine/distilled spirits pull) [Both

TION 10

1. Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
OYes INo 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?

DO Yes INo If yes, please provide the Name of the 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?

D1Yes MINo 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%.

Wisconsin Club of Sun City 100%

Name: Percentage:
Address: 11815 N 97th Avenue Sun City AZ 85351
Street City State Zip
Name: Percentage:
Address:
Street City State Zip
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_LL 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

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

|, (Print Full Name) Daryl Lund 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:

GOVERNING BOARD

Date Received:

\, recommend CIAPPROVAL CI DISAPPROVAL
(Goverment Official) (Tite)

On behalf of ‘
(City, Town, County)

Signature Date Phone

DLLC USE ONLY

CIAPPROVAL CI DISAPPROVAL BY: DATE:

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

Sechon \\

cut ciTy

[Submit byEmail | [Print Form

RECEIVED MAR 8 4 2021

ARIZONA
CLUB REQUEST FOR RCSC SANCTIONED EVENT
Club: Date of request:
Wisconsin Club of Sun City 3/31/21
Name of Event: Date(s) of Event:
Wisconsin Picnic 03/10/22
Location:
Sun Bowl
Times:
7:00AM - 4:00PM
Expected Attendance: Is this a yearly event? If yes, how many years:
1200 yes 30 (except for 2019 and 2020)
Set-up required by RCSC (ie. tables, chairs):
yes
Clean-up will be required by the Club. How many club volunteers will be involved to assure the event is a
success?
150

event? (i.e. porta potties, bleachers, food, etc.)
yes but no porta-potties

Will the club/sponsor be bringing in items to service the

If yes, provide details:

food,lawn chairs,electric cords, grills,4-piece band

area of the event? Please describe.
sufficient parking at the Sun Bowl

Is there sufficient parking for the event, or will there be overflow parking that could impact residents in the

Is the event sponsored by any person/organization?
yes

Wisconsin Club of Sun City,chartered RCSC Club

If yes, who?

Has the club hosted this event in the past? If so, when?
yes 03/14/2019
How will this event showcase Sun City?

by showing that SC residents know how to picnic with music and food

Club President

Daryl Lund

Email:

For Clubs Office use only

4

Received by Clubs: RECEIVED MAR 814 2021

if /

To Chartered “14 Lonny |
Clubs Supervisor: = (/-4) /_yv

7

/ i
Approved: ai A\ [SOA | Club notified: 1 A L303 |
Denied: Club notified:
Reason:
Club Request for Sanctioned Event Page 1 of 1 FORM BP:12-11 (June 2019)