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Arizona Department of Liquor Licenses and Control https://www.azliquor.gov (602) 542-5141 = DLLC USE ONLY TEMPORARY EXTENSION OF Date Accepted: PREMISES /PATIO PERMIT « A NON-REFUNDABLE $100 FEE WILL APPLY teense it *OBTAIN APPROVAL FROM LOCAL GOVERNING BOARD BEFORE SUBMITTING TO THE DEPARTMENT OF LIQUOR* APPLICATION MUST BE SUBMITTED TO THE DEPARTMENT OF LIQUOR 30 DAYS PRIOR TO FIRST SCHEDULED DATE License#: 1. Agent Name: Rivers Lisa First Middle Last 2. Business Name: BPOE #2160 3. Business Location Address: 123 N Frontier St_ Wickenburg, AZ 85390 Street City State Zip Code 4. Business Phone Number: 9286847714 Contact Phone Number: 9286710729 5. Mailing address: 123 N Frontier St Wickenburg, AZ 85390 Street City State Zip Code 6. Email Address: bpboe2160@gmail.com 7. Specific purpose for change: Octoberfest Event 8a. Do you understand Arizona Liquor Laws and Regulations? Vhes Lino b. Does this extension bring your premises within 300 feet of a school? Les [No Dates of the temporary extension - Must not exceed 6 months Date Day of the Week Start Time End Time 10/18/2025 Saturday 10:00 am 10:00 PM Must provide written notice to the Department of Liquor of any modification 10 days prior to change/addition to scheduled Temporary Extension. 5/51/2025 Page 1 of 2 Individuals requiring ADA accommodations please cak (602)542-2999 IMPORTANT- REQUIRED ATTACHEMENTS 1. MUST SUBMIT A SECURITY PLAN and identify security measures in order to: Provide for the safety of the patrons. Ensure no one under legal drinking age purchases, possesses, or consume alcohol. Prevent unauthorized removal of alcohol from the extended premises. Prevent unauthorized carrying of alcohol onto the extended premises. 2. MUST ATTACH A DIAGRAM, clearly depicting your licensed premises along with the new extended area, if the extended area is not outlined and marked “extension” we cannot accept the application. BARRIER Ol Barrier Exemption: an exception to the requirement of barriers surrounding a patio/outdoor serving area may be requested. Barrier exemptions are granted based on public safety, pedestrian traffic, and other factors unique to a licensed premises. List specific reasons for exemption: Oo Approval oO Disapproval by DLLC: SIGNATURE Declaration: 1, (Print Name) Lisa Rivers , declare under penalty of perjury that | am authorized by the licensee to submit this application. | have read the ve conse opie pplication and to the best of my knowledge believe all statements made on this application to be true, corre ta Sig GOVERNING BOARD j After completion, at least 60 days BEFORE submitting to the Department of Liquor, please take this application to your local Board of Supervisors, City Council or Designate for their recommendation. This recommendation is not binding on the Department of Liquor. O Approval im Disapproval Authorized Signature Title Agency DLLC USE ONLY Investigations: 0 Approval C1 Disapproval by: Director Signature required for Disapprovals: 5/51/2025 Page 2 of 2 Individuals requiring ADA accommodations please call (602)542-2999 OBE SOJBI|EGeD lesa % “war AWINDIS Jeq f suxg/eoueuy Li - ame, ‘ ze ¥ Wd 0:4 - Wd 00:7 SZz0Zz/8L/OL IS2SGoyO BinquaydsiM NiFrontieriStl_ — * Bad Wickenburg Oktoberfest 2025 October 18, 2025 4:00 pm- 7:30 pm Frontier St. & Yavapai St.