KNIGHTS OF COLUMBUS -REDACTED.PDF

Name: Knights of Columbus Council 12144 
Percentage: _1_0_0 ________ 
_ 
Address:
Street 
City 
Slate 
Zip 
Street 
City 
State 
Zip 
Please read A.R.S. § 4-203.02 Special event license: rules and Rl 9-1-205 Requirements for a Special Event License. 
ALL ALCOHOLIC BEVERAGE SALES MUST BE FOR CONSUMPTION AT THE EVENT SITE ONLY. 
NO ALCOHOLIC BEVERAGES SHALL LEAVE A SPECIAL EVENT UNLESS THEY ARE IN AUCJ!ON WINE OR QIST!LLEQ SPIRITS PULL 
SEALEQ CONTAINERS OR THE SPECIAL EVENT LICENSE IS STACKEQ WITH WINE /CRAFT QISJ!LLERY FESTIVAL LICENSE. 
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 locatlon 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: 
1, (Print Name) Frank J. Macedon 
, declare under penalty of perjury that I am 
authorized to submit this application. I have read the contents of this application, and to the best of my knowledge 
believe all statements made on th;s appl;caflon to be true, co~~~ 
Signature 
LOCAL GOVERNING BODY 
Date Received: ___ ____ _ 
I,---
- --------- ----------- recommend 
D APPROVAL 0 DISAPPROVAL 
(Government Official) 
(fdte) 
On behalf of __________ ________________________ _ 
(City. Town. County) 
Signature 
Date 
Phone 
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 to 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 
II 
DAPPROVAL D DISAPPROVAL 
BY: ______________ DATE:--------
2/6/2023 
Page 3 ot/ '1 
Individuals requiring ADA accommodations please call (602)542-2999 
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