SOUTHWEST WILDLIFE CONSERVATION CENTER_REDACTED.PDF

DLLC USE ONLY
Job #:
SPECIAL EVENT LICENSE
Date Accepted:
APPLICATION FEE $25.00 PER DAY
CSR:

Arizona Department of Liquor Licenses and Control
800 W. Washington St. 5" Floor Phoenix, AZ 85007 License #:

(602) 542-5141
Application MUST be submitted to the Department of Liquor 10 days prior to the event.

SECTION 7 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; Wilson, Robin Christine
(Must be an Officer/Member of the No; Middle
City State Zp
3. Applicants home/cell —_— fa Applicant's business phone: 602-677-1076

5. Special Event Name: Mesquite Canyon Trail Runs

6. Name of Non-Profit Organization, Candidate or Political Party/Gov: Southwest Wildlife Conservation Center

7. Non-Profit/IRS Tax Exempt Number: 86-0765249

8. Arizona Corporation Commission File #: O7 | & /2S0_If out of State please specify:

(Attach letter of good standing)
9. Event Location Name: White Tank Mountain Regional Park

10. Event Address: 20304 W. White Tank Mountain Road, Waddell, AZ 85355

Dates and Hours of Event - Days must be consecutive and 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
DAY 1: 03/11/2023 Saturday 8am {2am
DAY 2:
DAY 3:
DAY 4:
DAY 5: REGEIWED
DAY 6:

DEC 09 277
DAY 7: .
; MA! ™ COUNTY
DAY 8: CLERK BOARD OF SUPERVISORS
DAY 9:
DAY10:
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Individuals requiring ADA accommodations please call (602)542-2999

SECTION 2 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

ID check and wristbands to those 21 years of age and older. Security

Number of Police Number of Security Personnel [Fencing CoBarriers

Must explain security measures:

personnel will remain at the entrance/exit of the fenced in beer garden for the

duration of the event to ensure no alcohol leaves the designated beer garden.

SECTION 3 What is the purpose of this event?
[on-site consumption [loft-site (auction/wine/distilled spirits pull) Lboth

How is this special event going to conduct all dispensing, serving, and selling of spirituous liquors?
Check one of the following boxes. (R-19-318)

A) [4] Special Event being held on an unlicensed premises will require approval and signature by the Local Governing
Body on page 3. (If checked move to section 4)

B) [1] will this event be held on a currently licensed premises and within the already approved and licensed area?
(Must aitach a letter from the licensed premises with an explanation of the option checked below)

Name of Business License Number Phone (Include Area Code)

[Place license in non-use - Special Event Licensee selling all alcohol without retailer involvement
Must attach letter from the location suspending license for duration of special event

Libispense and serve all spirituous liquors under retailer's license — Business operates normally, minimum of 25% of gross
revenue from alcohol sales is donated to licensee

[dispense and serve alll spirituous liquors under special event - The special event licensee is in charge of selling alcohol that
was purchased or donated by the special event licensee. The retailers existing alcohol inventory must be separated from any
alcohol used during the special event. Must attach letter from the location suspending license for duration of special event

Lspiit premise between special event and retail location - Both the special event licensee and the retailer will conduct

sales of alcohol. (These sales will be done in separate areas. If alcohol is donated or purchased by the special event licensee
it must be in a separate area than the alcohol! that is dispensed by the licensed retailer.)

(loft sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer wil still be permitted to conduct all normal sale
and service of alcohol.

SECTION 4

1, Has the applicant been convicted of a felony, or had a liquor license revoked within the last five (5) years?
Dyes [4INo If yes, attach letter of 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 Special Event Contractor? (A licensee can utilize the services of a special
event contractor who may purchase and sell alcohol on behalf of the licensee. If no special event contractor is listed, the
licensee is responsible for the sales and service of alcohol. }

Aravaipa Running, LLC

Yes INo If yes, please provide the Name of the Special Event 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?
(Licensees who hold a series 6, 7, 11, or 12 license are automatically qualified to be the special event contractor)

(1 Yes[¥1No if yes, please provide the Name of Licensee: License #:

11/7/2022 Page 2 of 3
Individuals requiring ADA accommodations please call (602)542-2999

5. List the name of the Individual or Organization that will receive revenues, MUST EQUAL 100 PERCENT.
Attach additional sheet if necessary.

Name: Southwest Wildlife Conservation Center Percentage: 09
Address: 0/11 E Pinnacle Peak Rd, PMB 115 Scottsdale, AZ 85255
Name: Areva Fanning, LLC _ percentage: 35 .
Address: 2401 S 24th St Phoenix, AZ 85034

Street Clty State Zip

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 _5 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

If the 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 governing body before submitting
to the Department of Liquor Licenses and Control. Please contact the local governing board for additional information.

APPLICANT SIGNATURE

Declaration:

— Err im \

|, (Print Name) Boon Cn Vistine Wi (SON , 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 ‘complete.

Signature

LOCAL GOVERNING BODY

Date Received:

I, recommend LIAPPROVAL [1] DISAPPROVAL
(Government Official) (Title)

On behalf of

(City, Town, County) Signature

AZDLLC USE ONLY

CIAPPROVAL CI DISAPPROVAL BY:

11/7/2022 Page 3 of 3
Individuals requiring ADA accommodations please call (602)542-2999

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