Fair/Festival Application

CSR:

Amount:
DLLC USE ONLY
Job #:
FAIR/FESTIVAL LICENSE Date Accepted:
APPLICATION FEE $15.00 PER DAY ose
License #:
Arizona Department of Liquor Licenses and Control —_
800 W. Washington St. 5” Floor Phoenix, AZ 85007
(602) 542-5141
IN STATE OUT OF STATE
Seriestype: ( #3 Microbrewery [1] #2D CRAFT DISTILLERY EventType: [1] Festival
C) #13 Farm Winery [1] #2M MICROBREWERY 0) Fair
C #18 Craft Distiller [J #2W FARM WINERY
SECTION 1
1. Agent/Individual’s Name: Liquor License #:
2. Premises Name: Contact Phone #:
3. Mailing Address:
Street Address City State lip Code
4, Location of fair/festival:
Street Address City State lip Code

5, Email address:

6. Will this event be held on a permanently licensed premises and within the already approved location? [Wes [No
If yes, must attach letter from Agent/Owner verifying permission and event dates.
Must provide the permanent Liquor License/Special Event License at the event location:

SECTION 2 Date & Hours: A total of 150 days per calendar year permitted.

Days Date Day of Week Bea mah Soe ee

DAY 1:

DAY 2:

DAY 3:

DAY 4:

DAY 5:

DAY 6:

Day 7:

1/17/2024 Page 1 of 2
Individuals requiring ADA accommodations please call (602)542-2999

SECTION 3
1. List the number of days you have held a licensed Fair/Festival in the current calendar year

2. What security and control measures will you take to prevent violations of stafe liquor laws at this event?

Number of Police Officers on Site: Fencing Dyes no
Number of Security Personnel on Site: Barriers [yes [INo

Additional Information:

3. | have taken responsible steps to ensure individuals operating the fair/festival licensed premises and employees
who serve, sell, or furnish liquor at this fair/festival have knowledge of Arizona liquor laws (R19-1-302} Dhres..JNo

SECTION 4 Licensed premises diagram.
The licensed premises for your fair/festival is the area you are authorized to sell, dispense or serve alcoholic beverages
under the provisions of your license identified in Section 1, line #2 of this application. Please attach a diagram of

your special event licensed premise. Please include dimensions of the premises, serving areas, fencing, barricades,
or other control measures and security positions.

ATTACH DIAGRAM

SIGNATURE

Declaration:

|, (Print Name) . 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.

Signature

The local governing body (city, town or municipality where the fair/festival will take place) may require additional
applications fo 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.

GOVERNING BOARD

recommend DIAPPROVAL DIDISAPPROVAL

(Government Official) (Title)
on behalf of

(City, Town, County) ‘ Signature

DLLC USE ONLY

DIAPPROVAL (1 DISAPPROVAL BY:

1/17/2024 Page 2 of 2
Individuals requiring ADA accommodations please call (602)542-2999