VULTURE CITY PRESERVATION INC12.31.23_REDACTED.PDF
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RECEIVED NOV 0.7 2023 i MARICOPA COUNTY Amount: CLERK BOARD OF SUPERVISORS 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 P (602) 542-5141 Application MUST be submitted to the Department of Liquor 10 days prior to the event. License #: 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: Robin Moriarty (Must be an Officer/Member of the Non Profit Entit Last First Middle 2. Applicant's mailing address City State Zip 3. Applicants home/cell pho Applicant's business phone: 877-425-9229 4. Applicant's email address New Year Celebration 5. Special Event Name: 6. Name of Non-Profit Organization, Candidate or Political Party/Gov.: Vulture City Preservation Inc. 85-0876056 7. Non-Profit/IRS Tax Exempt Number: 8. Arizona Corporation Commission File #: 23070128 If out of State please specify: (Attach letter of good standing) 9. Event Location Name; Vulture City Ghost Town 36610 N355th Avenue, Wickenburg AZ 85390 10. Event Address: 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 Time AM/PM Time AM/PM payi. 12/31/23 Sunday 10AM 11:59PM Days Date Day of Week DAY 2: DAY 3: DAY 4: DAY 5: DAY 6: DAY 7: DAY 8: DAY 9: DAY10: 2/6/2023 Page 1 of 3 Individuals requiring ADA accommodations please call (602)542-2999 SECTION 2 What type of security and control measures will you take fo 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 2 Number of Security Personnel LoFencing ClBarriers There will be 2 staff members tending bar with an additional 2 security volunteers. ust explain security measures: All staff will be trained according to the policies and procedures outlined by the AZ Department of Liquor Licenses and Control SECTION 3 What is the purpose of this event? [4Jon-site consumption Cott-site (auction/wine/distilled spirits pull) CBoth Howis this special event going to conduct all dispensing, serving, and selling of spirituous liquors? Check one of the following boxes. (R-19-318) A) 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) C1 will this event be held on a curently licensed premises and within the already approved and licensed area? (Must attach a letter from the licensed premises with an explanation of the option checked below) Name of Business License Number Phone (Include Area Code) CPlace 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 LDbispense and serve alll spirituous liquors under retailer's license — Business operates normally, minimum of 25% of gross revenue from alcohol sales is donated fo licensee Libispense 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 Displit 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 alcoho! 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.) Cot sale only - Wine/Distilled Spirits Pull, Live or Silent Auctions — Retailer will 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? (Yes [J No If yes, attach letter of explanation. 2. How many special event days have been issued to this organization during the calendar year? 6 3. Is the Organization using the services of a Special Event Contractor? (A licensee can uiilize 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. ) (1 Yes HINo If yes, please provide the Name of the Special Event Contractor: 4, ls 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) OYes HINo if yes, please provide the Name of Licensee: License #: 5. List the name of the Individual or Organization that will receive revenues, MUST EQUAL 100 PERCENT. Attach additional sheet if necessary. 2/6/2023 Page 2 of 3 Individuals requiring ADA accommodations please call (602)542-2999 Name: Vulture City Preservation Inc. Percentage: 100% <r Street City State Zip Name: Percentage: Address: Street City State Tip 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. mm ATTACH DIAGRAM aaa 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 confact the local governing board for additional information. APPLICANT SIGNATURE Declaration: |, (Print Name) Robin Moriarty , declare under penalty of perjury that | am authorized to submit this application. | have read the contents of this a jon, and to the best of my knowledge believe all statements made on this application to be true, correctéfnd compjete. <8 Signature \ LOCAL GOVERNING BODY Date Received: I, recommend LIAPPROVAL [1 DISAPPROVAL (Government Official) (Title) On behalf of , , , (City, Town, County) Signature Date Phone — ———— ——— a pee ———— a The local governing body (city, town or municipality where the fair/festival will take place) may require additional applications to 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. AZDLLC USE ONLY DIAPPROVAL LI DISAPPROVAL BY: DATE: EE 2/6/2023 Page 3 of 3 Individuals requiring ADA accommodations please call (602)542-2999 Blue Highlighted building known as the Original Cookhouse & Bar will be the Serving Area. Bar will have 2 servers at all times The property is completely contained by fencing with only one way in and one way out as demonstrated by the red lines. Both the entrance and exit will have volunteer security at all times