HomeMy WebLinkAbout04/04/2022 Item 005 SECTION.¢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.)
Number of Police 75 Nun'ibor of Security Personnel Q✓Fencing E Barriers
Explanation: The venue is secured with fence panel. All service stations are
required to request proper ID of proof of age. Wrist bands will be issued.
Each purchase will be required to show proof of age each time.
SECTION 7 WIII this event be held ort a cilrrently licensed premise and wltnln the already approved premises?Qyes ✓No
(If yes, Local Governing Body Signature not required)
Name of Business License Number Phone(Include Area Code)
SECTION How is this special event going to conduct ail dispensing,serving,and selling of spirituous liquors? Please read 2-19-
318 for explanation and check one of the fallowing boxes.
QPlace license in non-use
Dispense and serve all spirituous liquors under retailer's license,
E]✓ Dispense and serve all spirituous liquors under special event
[35pGt premise between special event and retail location
(IF USING RETAIL LICENSE, PLEASE SUBMIT A LETTER OF AGREEMENT FROM THE AGENT/OWNER OF THE LICENSED PREMISES TO SUSPEND OR RUN
CONCURRENT WITH THE PERMANENT LICENSE DURING THE EVENT. IF THE SPECIAL EVENT IS ONLY USING A PORTION OF THE PREMISES,
AGENT/OWNER WILL NEED TO SUSPEND THAT PORTION Of THE PREMISES.]
SECTION 9 What is the purpose of this event?
57 On-site consumptior -]Off-site (auct+on/wine/d st'lled spirits pull; ❑Both
SECTION 10
1.(HHa},s the applicant beer, convicted of a felony, or had a liquor license revoked within the last five (5) years?
Ur es[DNo(if yes,attach explanation.)
2. How runny special event days have been issued to this organization during the calendar year?
(The number cannot exceed 10 days per year.)
3. Is the organization using the services of a licensed contractor or other person to manage the sale or service of alconol?
llyeS[a)o(if yes,must be a licensed contractor or licensee of series 6,7,11,or 12)
4, list all people and organizations who will receive the proceeds. Account for 100%fl of the proceeds. The organization
applying must receive 25%of the gross revenues of the special event liquor sales.Attach an additional page if necessary.
Name
HolyThunder Saloon - Ministry Percentage: ,25%0
._. .._.___
Address 3212 East Garnet Lane, Orange Ca. 92869
Rockabilly Reunion 75%
Name... --._ . -.........---Percentage: ----- ----
Address 12672 Limonite Blvd. 3E #118, EaStvale California 92880
..._........_._...-..._.._.._ _._._.._._...__._.. _
Street City State Zip
91?I9/2018 Page 2 of 4
Inhwicduah requirinta ADA r;i:comrnodations cull (602)542-2999
Please read A.R.S. §4-203.02 Special event license:rules and R 19-1-205 Requirements for a Special Event license.
Note: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 AUCTION WINE OR DISTILLED SPIRITS FULL
SEALED CONTAINERS OR THE SPECIAL EVENT LICENSE IS STACKED WITH WINE/CRAFT DISTILLERY FESTIVAL LICENSE.
SECTION 11 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 government before submission to the
Department of Liquor Licenses and Control. Please contact the local governing board for additional application requirements and
submission deadlines. Additional licensing fees may also be required before approval may be granted. For more information, please
contact your local jurisdiction.
NOTARY
I,(Print Pull Name) MA t2< Do n(-IG t hereby declare that I am the APPLICANT,I have read this dociment
and verify the contents and all statements are true. correct and complete to the best of my knowledge.
X(Signature) t ... State of e x_4 .County of DJ «-�
Applicant Signature the foregoing 1 ument was acknowledged before me this
rlot
Day Month Year
My commi A241Z---
Anne Campanaro -
Notary Public
E Mohave County,Arizona Signatvre of N07AI PUBLIC
My Comm.Expires 09-02-2022
Commission No.550810
9/19/20'8 ?age 3 of 4
Individuals requiring ADA accommodations rail(6021542-2999
This is a written agreement made between the event promoter of the Colorado River Run-Rockabilly
Reunion Rockabilly Production & Holy Thunder Saloon- Ministry.
This agreement is required by the Arizona Department of Liquor Licenses&Control that the
Organization (Holy Thunder Saloon)that will be applying for the State of Arizona Department of Liquor
Licenses and Control Alcoholic Beverage License—will receive 25%of the proceeds of the event The
Colorado River Run held April 22 & 23, 2022.
Rockabilly Reunion/ Rockabilly Productions the organizer of the event will receive 75%of proceeds.
Rockabilly Reunion/ Rockabilly Productions
12672 Limonite Ave. Ste 3E#118
Eastvale, Ca. 92880
Holy Thunder Saloon—Ministry Holy Thunder Saloon—Mark Donnell
3212 East Garnet Lane 2317 Tigertail Drive
Orange,Ca., 92869 Lake Havasu City,Az., 86403
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