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HomeMy WebLinkAbout2001.0802.TCREM.PacketN �l
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Councilman McNeill
Vice Mayor Wyman
Councilwoman Fraverd
NOTICE OF REGULAR AND EXECUTIVE
SESSION OF THE
FOUNTAIN HILLS TOWN COUNCIL
Mayor Morgan
Councilwoman Hutcheson
Councilman Kavanagh
Councilwoman Ralphe
WHEN: THURSDAY, AUGUST 2, 2001
TIME: 5:30 P.M. (THE COUNCIL WILL BE IN EXECUTIVE SESSION
FROM 5:30 P.M. TO 6:30 P.M. THE REGULAR SESSION WILL
BEGIN PROMPTLY AT 6:30 P.M.)
WHERE: TOWN HALL COUNCIL CHAMBERS
16836 E. Palisades, Building B
RULES FOR ADDRESSING THE COUNCIL — ADOPTED 1118190
Ike Council's desire to hear public comment on agenda items. As it is important to maintain order during the meeting, please adhere to
the following rules of order if you wish to speak:
All citizens wishing to speak must first be recognized by the Mayor.
1.) The Mayor will not call for public comment on an item until after a motion has been made and seconded and the Council has
had adequate opportunity to discuss the item.
2.) Please stand, approach the microphone and state your name and address after being called on to speak.
3.) All comments must be directed to the Mayor.
4.) TIME LIMIT — THREE (3) MINUTES PER PERSON PER ITEM.
5.) Statements should not be repetitive.
6.) Persons or groups wishing to make longer presentations should see the Town Clerk prior to the meeting.
• CALL TO ORDER — Mayor Morgan
• ROLL CALL
1.) Pursuant to A.R.S. 38-431.03.A.1, AND A.R.S. §38-431.03.A.7., VOTE TO GO INTO EXECUTIVE SESSION
for discussion or consideration of employment, assignment, appointment, promotion, demotion, dismissal, salaries,
disciplining or resignation of a public officer, appointee or employee of any public body, except that with the
exception of salary discussions, an officer, appointee or employee may demand that such discussion or consideration
occur at a public meeting. The public body must provide the officer, appointee or employee with such personal notice
of the executive session as is appropriate but not less than 24 hours for the officer, appointee or employee to
determine whether such discussion or consideration should occur at a public meeting; (the Council will be discussing
renewal and changes to the employment contract of Town Manager, Paul Nordin, who is currently on disability leave;
the Council will also discuss compensation for the Acting Town Manager); AND discussions or consultations with
designated representatives of the public body in order to consider its position and instruct its representatives regarding
negotiation for the purchase or lease of real property (specifically sections of state land northeast of Fountain Hills);
respectively.
Town of Fountain Hills Page 1 of 3 Last printed 07/26/01 12:47 PM
2.) RETURN TO REGULAR SESSION
• CALL TO ORDER — Mayor Morgan
• PLEDGE TO THE FLAG
• INVOCATION — Pastor Dennis Daniel, First Baptist Church
• ROLL CALL
Mayor's Report: Mayor Sharon Morgan will give an update on the medical condition of
Town Manager Paul Nordin.
Consent Agenda:
All items listed with an asterisk (') are considered to be routine, non -controversial matters and will be enacted by one motion and one roll call vote of
the Council. All motions and subsequent approvals of consent items will include all recommended staff stipulations unless otherwise stated. There
will be no separate discussion of these items unless a Councilmember or member of the public so requests. If a Councilmember or member of the
public wishes to discuss an item on the consent agenda, they may request so prior to the motion to accept the consent agenda. The item will be
removed from the Consent Agenda and considered in its normal sequence on the agenda.
*1.) Consideration of APPROVING THE MEETING MINUTES of June 26, 27 and July 5, 16, 2001.
*2.) Consideration of the LIQUOR LICENSE APPLICATION submitted by Al Poma for Fountain View Village
located at 16455 Avenue of the Fountains. The application is for a new Class 12 Restaurant license.
*3.) Consideration of ORDINANCE 01-13 amending the Town Code, Chapter 10, Health and Sanitation, Article
10-1 Methods of Garbage and Trash Removal by adding Sections 10-1-5 regarding Fly -Tight and Clean
Garbage Containers; 10-1-6 Inspections; 10-1-7 Enforcement; and 10-1-8 Recycling. (Ordinance and staff
report will be provided prior to the meeting.)
L *4.) Consideration of a PRELIMINARY AND FINAL PLAT for the forty-five unit Fiesta Casitas Condominiums,
located at 16354 E. Palisades, Boulevard, aka Plat 103, Block 1, Lot 16, Case Number S2001-19.
*5.) Consideration of a FINAL REPLAT of Lots 80 and 81, Diamante Del Lago Final Plat, a common lot line
adjustment, located between 13624 and 13628 N. Bonita Drive, Case Number S2001-21.
*6.) Consideration of RESOLUTION 2001-40, abandoning whatever right, title, or interest the Town has in certain
public utility and drainage easements located along the southerly and easterly property lines of Lot 12, Plat 206,
Block 3, (16529 East Lost Arrow Drive) as recorded in Book 147 of Maps, Page 2 Records of Maricopa
County, Arizona. (Roger & Hannelore Thrall) EA01-18.
7.) RECOGNITION of local volunteer Red Cross/shuttle drivers and update on the Red Cross's recently
implemented central dispatch service and expanded local program.
8.) REVIEW AND UPDATE by Mr. Robert Sternfels regarding the adhoc FAA/Sky Harbor air traffic
committee's recent activities.
9.) UPDATE AND RECOMMENDATION by Community Center Advisory Commission Chairman, Wally
Nichols and Community Center Director, Jim Willers, on the Commission's review of the fee schedule for non-
profit organizations.
10.) PUBLIC HEARING on RESOLUTION 2001-39, adopting the tentative budget as the 2000-2001 fiscal year
budget for the Town of Fountain Hills.
11.) Consideration of adopting RESOLUTION 2001-39, adopting the tentative budget as the 2000-2001 fiscal year
budget for the Town of Fountain Hills.
12.) Consideration of RESOLUTION 2001-34 amending the personnel policies and procedures for the Town of
Fountain Hills by amending policy 6.5 Sick Leave; and 6.6 Funeral Leave.
Town of Fountain Hills Page 2 of 3 Last printed 07/26/01 12:47 PM
Town Council Meeting Agenda Regular Session August 2, 2001
13.) Consideration of a TOWN COUNCIL INITIATED AMENDMENT to Sections 6.02 and 6.03 of The Zoning
Ordinance for the Town of Fountain Hills to prohibit neon signs.
14.) PUBLIC HEARING on a SPECIAL USE PERMIT for Polese Pest Control for a pest control home
*"" occupation located at 15833 Ruskin Lane, Case Number SU2001-07.
15.) Consideration of a SPECIAL USE PERMIT for Polese Pest Control for a pest control home occupation
located at 15833 Ruskin Lane, Case Number SU2001-07.
16.) PUBLIC HEARING on a Special Use Permit to allow the storage and use of hazardous materials as a part
of the business services used at a proposed manufacturing facility located at 16611 East Laser Drive, #101,
aka Final Plat 414, Lot 52, Case Number SU2001-08.
17.) Consideration of a SPECIAL USE PERMIT to allow the storage and use of hazardous materials as a part of
the business services used at proposed manufacturing facility located at 16611 East Laser Drive, #101, aka
Final Plat 414, Lot 52, Case Number SU2001-08.
18.) DISCUSSION AND POSSIBLE ACTION regarding the renewal and amendment to the employment contract
of Town Manager Paul Nordin specifically concerning annual compensation and fringe benefits.
19.) DISCUSSION AND POSSIBLE ACTION regarding a rate of compensation to be paid to Acting Town
Manager William Farrell. The compensation will be in addition to the current contract for legal services.
20.) CALL TO THE PUBLIC.
Pursuant to A.R.S. §38-431 -01 (G), public comment is permitted (not required) on matters not listed on the agenda but must be within the jurisdiction
of the Council. All comment is "subject to reasonable time, space and manner restrictions" and the Council will not discuss or take legal action on
Wmatters raised during call to the public unless the matters are properly noticed for discussion and legal action. At the conclusion of the call to the
public individual Council members may respond to criticism, ask staff to review a matter or ask that a matter be put on a future agenda.
21.) ADJOURNMENT.
DATED this 24h day of July, 2001 n44 j- aM44—.-i
Cassie B. Hansen, Director of Administration/Town Clerk
The Town of Fountain Hills endeavors to make all public meetings accessible to
persons with disabilities. Please call 837-2003 (voice) or 1-800-367-8939 (TDD)
48 hours prior to the meeting to request a reasonable accommodation to
participate in this meeting or to obtain agenda information in large print format.
Supporting documentation and staff reports furnished the council with this agenda are available for review in the Clerk's office.
Town of Fountain Hills Page 3 of 3 Last printed 07/26/01 12:47 PM
MEMORANDUM
i
TO: THE HONORABLE MAYOR MORGAN AND
TOWN COUNCILMEMBERS
FROM: WILLIAM E. FARRELL, ACTING TOWN MANAGER
DATE: JULY 27, 2001
RE: MANAGER'S REPORT FOR THE AUGUST 2ND COUNCIL
MEETING
REMINDERS:
An Executive Session is scheduled to immediately precede the Thursday's regular
meeting at 5:30 p.m. in the Jury Room. A light fare will be available. The Council
meeting will immediately follow at 6:30 p.m. in Council Chambers.
CONSENT AGENDA:
There are six items on the consent agenda. Please review each item and contact me
should you determine if any should be removed.
AGENDA ITEM # 7 — RECOGNITION OF RED CROSS VOLUNTEER
DRIVERS/UPDATE ON TRANSPORTATION SERVICES:
Mayor Morgan will present recognition certificates and commemorative pins to the
volunteer Red Cross drivers who have donated many hours of their time in serving
their community. Representatives from Maricopa County Human Services and the
American Red Cross will then make a short presentation on expanded transportation
and dispatching services. Sue's memo is attached.
AGENDA ITEM # 8 — UPDATE ON FOUNTAIN HILLS AIR TRAFFIC
COMMITTEE'S ACTIVITIES:
Bob Sternfels, a member of the Mayor's adhoc FAA/Sky Harbor air traffic
committee, will update the Council on the group's recent activities. No material is
attached pertaining to this item.
AGENDA ITEM # 9 — CONSIDERATION OF REVISED FEE SCHEDULE
FROM THE COMMUNITY CENTER ADVISORY COMMISSION:
Wally Nichols, Chairman of the Community Center Advisory Commission, and Jim
Willers, Community Center Director, will discuss the revised rental fee schedule for
non-profit organizations. The Community Center Advisory Commission members,
at the Town Council's direction from the July 51h meeting, re -assessed the rental fee
Town Manager's Report
August 2, 2001 Council Meeting
Page 1 of 2
schedule and submitted their revised recommendation. Please see Jim's enclosed
report.
AGENDA ITEMS # 10 & #11— PUBLIC HEARING/RESOLUTION 2001-39/
ADOPTION OF FISCAL BUDGET:
The first public hearing is scheduled to satisfy the State law requirement and
continue the process to adopt the fiscal year 2002-2002 budget. Please refer to
Cassie's enclosed report. I have also attached pages 3-2 and 3-3 from the budget
showing the revenue and expenditure summaries.
AGENDA ITEM # 12 — RESOLUTION 2001-34/AMENDMENT TO
PERSONAL LEAVE POLICY:
Council members expressed concerns and had questions regarding some of the
Benefit Committee's recommendations presented at the June 26`h budget session.
The Committee has since reconvened to discuss possible revisions, taking the
Council's comments into consideration. A resolution has been prepared to reflect the
changes. Attached please find Cassie's memo detailing the revised version.
AGENDA ITEM # 13 — AMENDMENT PROHIBITING NEON SIGNS:
This item was suggested by Councilmember Kavanagh at a previous council meeting
and is the initiation of a text amendment. Please see Jeff's memo.
AGENDA ITEMS # 14 & # 15 — PUBLIC HEARING/SPECIAL USE PERMIT/
15833 RUSKIN LANE/PEST CONTROL MATERIALS STORAGE:
The next public hearing is on the agenda to receive input regarding an application to
operate a pest control service at 15833 Ruskin Lane. After the hearing, Council will
consider the request to allow for a home occupation pest control business, including
the storage of pest control supplies. The Planning and Zoning Commission and staff
recommend approval, with stipulations. Dana's report is enclosed.
AGENDA ITEMS # 16 & # 17 — PUBLIC HEARING/SPECIAL USE PERMIT/
16611 EAST LASER DRIVE/HAZARDOUS MATERIALS STORAGE:
This public hearing concerns a special use permit request to allow the storage and
use of "hazardous materials" at 16611 East Laser Drive. This special use permit is
required because the prior special use permit is valid only at the current location and
cannot be transferred to the new building location. The Planning and Zoning
Commission and staff recommend approval. Please see Jesse's attached memo.
AGENDA ITEMS #18 & #19 — TOWN MANAGER CONTRACT/APPROVAL
OF COMPENSATION RATE FOR ACTING TOWN MANAGER:
These items will be discussed as permitted by law in Executive Session and a
suggested form of motion will be provided to the Council.
Town Manager's Report
August 2, 2001 Council Meeting
Page 2 of 2
Interoffice Memo
To: HONORABLE MAYOR AND TOWN COUNCIL
From: CASSIE HANSEN, DIRECTOR OF ADMINISTRATI(N,v
Date: 07/25/01
Re: AGENDA ITEM #2 — FOUNTAIN VIEW VILLAGE LIQUOR LICENSE
In his capacity as food service manager, Al Poma has submitted an application for a new Class 12
Restaurant license for Fountain View Village located at 16455 Avenue of the Fountains. This license will
be used in conjunction with the dining room services provided at the new Fountain View Village "senior
living facility". Marshal Gendler performed a site inspection and verified that the statutory requirements
of a Class 12 license have been satisfied. (Please see attached memo from Steve.) The premise was
posted for the statutory twenty -day period and no written arguments were received at Town Hall. The
owner, Fountain View LLC, has obtained a valid Fountain Hills business license. Based on statutory
compliance, staff recommends approval.
Page 1 of 1 August 2, 2001 Agenda Item #2 Last printed 07/25/01 12:29 PM
07/25/01
Town of Fountain Hills Memorandum
TO: Cassie Hansen
FROM: Steve Gendler
DATE: July 6, 2001
SUBJECT: Liquor License Application — Fountain View Village
------------------------------------------------------------------
The purpose of this memorandum is to provide an endorsement of the attached liquor license
application for the "Fountain View Village" to be located at 16455 Avenue of the Fountains. It is my
understanding that the application is scheduled for consideration the Council session on August 2nd.
This application is for a new Class 12 liquor license under the specifications of ARS 4-
205.02. A Class 12 license is for restaurant use only. A site inspection showed that this
license will be used in conjunction with the dining room services at the new Fountain View
Village "senior living facility" on Avenue of the Fountains south of Walgreen's.
The statutes require that 40% of an establishment be devoted to serving food and that liquor
sales be incidental to the food service. The building in which the 800 square foot bar area is
located features two kitchens totaling 1900 square feet and three dining rooms totaling 5400
square feet. The liquor, kitchen and dining areas are all within one self contained building
which is clearly dedicated to the service of food and support amenities for the residents.
A Class 12 license is exempt from restrictions relating to churches, schools and nearby liquor
establishments. However, the local jurisdiction does have the ability to determine if there is a
proliferation of liquor establishments in the vicinity. A review of license holders in the
immediate area indicates there are three class 6s, three class 10s, five class 12s, and one class
14 within one-half mile. These licenses are consistent with "downtown" development as well
as commercial zoning and do not represent a proliferation issue in this case. Moreover, the
license will be used in a very specialized capacity serving the dining area for the facility's
residents and guests.
The applicant, Al Poma, is the food service manager and an Arizona citizen residing in
Fountain Hills. He is filing the application on behalf of the corporation, "Fountain View
LLC". There are no outstanding wants or warrants on the applicant or the corporate partners.
Additionally, the owners have secured a valid Fountain Hills business license (#4470).
Based on compliance with Title 4 relating to the Class 12 liquor license, the fact that the
applicant is an Arizona resident with no wants or warrants, and that the owners have secured
a Fountain Hills business license, I recommend approval by the Council on August 2nd
Business License Verification
To: Public Safety Director Steve Gendler
From: Bev Bender, Executive Assistant to the Town Clerk
Date: 2 C'
Applicant:
Applicant's address: �l��5��/� d� 5 z7Y
Business License: '/70
// /
Business License effective period:
,. � ,L � � � (,c•,�.�.G�ii_- � fir' U J
0
'PnA IZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL
RECEIVED
800 W Washington 5th Floor JUN 2 400 W Congress #150
20
Phoenix AZ 85007-2934 °'� - /�l �.T cson AZ 85701-1352
(602) 542-5141 Hiu (*D
JlAr 21- (520) 628-6595
a%
APPLICATION FOR LIQUOR LICENS / V/
TYPE OR PRINT WITH BLACK INK
Notice: Effective Nov. 1,1997, All Owners, Agents, Partners, Stockholders, Officers, or Managers actively involved in the day to day
operations of the business must attend a Department approved liquor law training course or provide proof of attendance within the last
five years. See page 5 of the Liquor Licensing requirements. j 3t O S -7
SECTION 1 This application is for a:
❑ INTERIM PERMIT Complete Section 5
NEW LICENSE Complete Sections 2, 3, 4,13, 14, 15,16,17
PERSON TRANSFER (Bars & Liquor Stores ONLY)
Complete Sections 2, 3, 4, 11, 13, 15, 16, 17
❑ LOCATION TRANSFER (Bars and Liquor Stores ONLY)
Complete Sections 2, 3, 4,12,13, 15,16,17
❑ PROBATE/WILL ASSIGNMENT/DIVORCE DECREE
Complete Sections 2, 3, 4, 9,13,15,17 (fee not required)
❑ GOVERNMENT Complete Sections 2, 3, 4,10,13,15,16,17
SECTION 3 Type of license and fees:
LICENSE #:
SECTION 2 Type of ownership: f6Jt (o -1 g. U 1
❑ J.T.W.R.O.S. Complete Section 6
❑ INDIVIDUAL Complete Section 6 LA'DU r LA.
❑ PARTNERSHIP Complete Section 6
El -CORPORATION Complete Section 7
15 LIMITED LIABILITY CO. Complete Section 7
❑ CLUB Complete Section 8
❑ GOVERNMENT Complete Section 10
❑ TRUST Complete Section 6
❑ OTHER Explain
1. Type of License: •u 2. Total fees attached: $
APPLICATION FEE AND INTERIM PEI VIIT FEES (IF APPLICABLE) ARE NOT REFUNDABLE.
,` A service fee of $25.00 will be charged for all dishonored checks (A.R.S. 44.6852)
SECTION 4 Applicant: (All applicants must complete this section) I O 3
W4G� 1. pplicandAgent's Name: Ms.
�seecnt one nanre ONLY to appear on license) Last First Middle
2. Corp./Partnership/L.L.C.: ��% �i n/ t ri i AI 1 K 6— �Z . L . L L 6' Dz 9747M
(Exactly
Yas it appears on Articles of Inc. or Articles of Org.) �� f
3. Business Name: v / ' G Z 09 o e � f
(Exactly as it appears on the exterior of premises)
4. Business Address: l e t/ S S A I/ it /'-
/I/¢�9iiN A6 ySzr-e
r 4 not use PO Box Numberr I City COUNTY Zip
5. Business Phone: (�D Residence Phone: (Vio") if-1 % V ��
�Is the business located within the incorporated limits of the above city or town? YES ❑NO
7. Mailing Address: 111 T A./ G a
City State Zip
8. Enter the amount paid for a 06, 07, or 09 license:
Accepted by: b I n
Fees: I OO
Application Interim Permit
(Price of License ONLY)
DEPARTMENT USE ONLY
Date: � b I
Agent Change Club
Lic. # 12 0 �
$�
F. Prints TOTAL
PROCESSING APPLICATIONS TAKES APPROXIMATELY 90 DAYS, AND CIRCUMSTANCES OFTEN RESULT IN A LONGER WAITING PERIOD.
YOU ARE CAUTIONED REGARDING PLANS FOR A GRAND OPENING, ETC., BEFORE FINAL APPROVAL AND ISSUANCE OF THE LICENSE.
LIC 0100 07/2000 *Disabled individuals requiring special accommodation, please call the Department.
SECTION 5 Interim Permit:
AZ L/O in1. If you intend to operate business while your application is pending you will need an Interim Permit pursdAflt to A.R.S. 4203.01.
2. There MUST be a valid license of the same type you are applying for currently issue t locatjo . a
3. Enter the license number currently at the location. .5 t II 0j
4. Is the license currently in use? ❑ YES ❑ NO If no, how long has it been out of use?
ATTACH THE LICENSE CURRENTLY ISSUED AT THE LOCATION TO THIS APPLICATION.
1, declare that I am the CURRENT LICENSEE of the stated license and
(Print full name)
location . I have read this application and the contents and all statements are true, correct and complete.
State of County of
X The foregoing instrument was acknowledged before me this
(Signature)
day of
Day of Month Month Year
My commission expires on:
(Signature of NOTARY PUBLIC)
SECTION 6 Individual or Partnership Owners:
EACH PERSON LISTED MUST SUBMIT A COMPLETED FORM "LIC0101 ", AN "APPLICANT" TYPE FINGERPRINT CARD, AND $24 FEE FOR EACH CARD.
1. Individual:
Last Fast Middle % Owned Residence Address City State Zip
E--::�-- I %I I
Partnership Name: (Only the first partner listed will appear on license)
C;erwMI-l.imiteri Tact Frst Middle %Owneci
Re--cidewp.. Addrrcc City Ct.te rn
❑ ❑
%
❑ ❑
%
❑ ❑
%
(ATTACH ADDUIONAL SHEET IF NECESSARY)
2. Is any person, other than the above, going to share in the profits/losses of the business? ❑ YES ❑ NO
2
JUN-22-01 FRI 11;26 AM
P
THE
VINTAGE COMPANY
Mr, Edwin D. Schoening
% First Management, Inc.
1941 S. 42" d Street 4550
Omaha, NE 68105-2982
Mr. Frank Krejci
% Century Development Company
3323 North 107"' Street
Omaha, NE 68134
Mr. William F. McVey
One Westlake Village
Council Bluffs, IA 51501
I
Mr, Norman D. Riffel
`/o A-1 Metro Movers
10919 Sapp Bros. Drive
Omaha, NE. 68138
Mr. 'Terrance A. Hogan
% First Management, Inc.
1941 S. 42"d Strcct -4550
Omaha, NE 68105-2982
Mr. Craig W. Hansen
% Hansen Company, Inc.
8145 East Evans Road, Suite 2
Scottsdale, AL 85260
Vintage Companies, L.L.C.
Attn: Michael Wilcox
14216 Dayton Circle
Omaha, NE 68137
Mr. Bradley L. Lee
1315 Cole Creek Drive
Omaha, NF, 68114
FAX;4028619619 PAGE 4
A? LIQ LIC
FOUNTAIN V 7. W L. ;
Ownership
Phone 402-344-4600 27.77%
FAX 402-344-4602
SS # 478-40-191 .1
Phone 402-493-6165 19.936/y
FAX 402-493-4900
SS # 507-14-9465
Phone712-330-5170 17.81% 1
FAX 712-330-5170
SS # 496-34-4844
Phone 402-895-1930 13.89%
FAX 402-895-3479
SS # 512-36-2933
Phone 402-344-4600 9,48%
r,AX 402-344-4602
SS # 506-74-0265
Phone 480-348-8999 5.56%
FAX 480-348-8998
SS # 485-68-3273
Phone 402-861-9622 2,78%
FAX 402-861-9619
ID # 47-0762307
Phone 402-598-1192 2.78%
FAX 402-391-56.13
SS # 508-64-2570
SECTION 7 Corporation/Limited Liability Co.: ` '-I 11 C
EACH PERSON LISTED MUST SUBMIT A COMPLETED FORM " UCO101 ",IN "YTLICANT'TYPEFI PRINT CARD, AND $24 FEE FOR EACH CARD.
err► ❑ CORPORATION Complete questions I, 2, 3, 5, r 7, 8
L.L.C. Complete questions I, 2, 4, 5i'
,6,I7 and attach copy of Articles of Org. and Operation Agreement.
1. Name of Corporation/L.L.C.: _ rO U 1114 q i 111 !i 15 0 Z L 61
I (Exactly as it appears on Articles of Inc. or Articles of Org.)
2. Date Incorporated/Organized:
3. AZ Corporation Commission File No.:
State where Incorporated/Organized: — *V1
Date authorized to do business in AZ:
� 4. AZ L.L.C. File No: L �� (� �-I 3 Date authorized to do business in AZ: �"- Z �—� 9/
!!5. Is Corp./L.L.C. non-profit? YESIE If yes, give IRS tax exempt number.
CJ List all directors/officers in Corporation/L.L.C.:
Last First Mule Tide Rp-giA p A`4kvee
(ATTACH ADDITIONAL SHEET IF NECESSARY)
V List stockholders or controlling members owning 10% or more:
st First Middle % Owned Residence Address Ci State Zi
%
(ATTACH ADDITIONAL SHEET IF NECESSARY)
8. If the corporation/L.L.C. is owned by another entity, attach an ownership, and director/officer/members disclosure for the parent
entity. Attach additional sheets as necessary in order to disclose real people.
SECTION 8 Club Applicants:
EACH PERSON LISTED MUST SUBMIT A COMPLETED FORM "LIC0101 ",AN "APPLICANT' TYPE FINGERPRINT CARD, AND $24 FEE FOR EACH CARD.
1. Name of Club:
(Exactly as it appears on Club Charter)
2. Is club non-profit? ❑ YES ❑ NO If yes, give IRS tax exempt number:
3. List officer and directors:
Last
First Middle Tide
Date Chartered:
Residence Address
(Attach a copy of Club Charter)
State
(ATTACH ADDITIONAL SHEET IF NECESSARY)
3
SECTION 9 Probate, Will Assignment or Divorce Decree of an existing Bar or Liquor Store:
1. Current Licensee's Name:
(Exactly as it appears on license) Last AZ LIQ `I C First Middle
2. Assignee's Name: j �j
Last �um 25 J �j� t �i ! B U Middle
3. License Type: License Number: Date of Last Renewal:
4. ATTACH TO THIS APPLICATION A CERTIFIED COPY F THE WILL, PROBATE DISTRIBUTION INSTRUMENT, OR DIVORCE
DECREE THAT SPECIFICALLY DISTRIBUTES THE LIQ OR LICENSE TO THE ASSIGNEE TO THIS APPLICATION.
SECTION 10 Government: (for cities, towns, or
1. Person to administer this license:
2. Assignee's Name:
Last
Last
SECTION 11 Person to Person Transfer:
Questions to be completed by CURRENT LICENSEE
1. Current Licensee's Name:
(Exactly as it appears on license)
2. Corporation/L.L.C. Name:
3. O.---ant Business Name:
4. Current Business Address:
Last
(Exactly as it appears on
(Exactly as it appears on
5. License Type: License
6. Current Mailing Address (other than business): _
7. Have all creditors, lien holders, interest
8. Does the applicant intend to operate
current license to this application.
?s only)
t Middle
Fust Middle
�H P ISES FROM WHICH SPIRITUOUS LIQUOR IS SERVED.
/dLiquor Stores ONLY).
Entity:
Middle (Indiv., Agent, etc.)
Last Renewal Date:
etc. been notified of this
while this application is
9. I hereby relinquish my rights to the above described license to the applicant
made in this section are true, correct and complete.
I, , declare that I am the C
(Print full name)
application and the contents and all statements are true, correct and complete.
(Signature of CURRENT LICENSEE)
My commission expires on:
❑ YES ❑ NO
❑ YES ❑ NO If yes, complete section 5, attach fee, and
in this application and hereby declare that the statements
LICENSEE of the stated license. I have read this
State oy 1 County of
The foregoing instrument was acknowledged before me this
_ day of
Day of Month Month Year 10)
fcl
(Signature of NOTARY PUBLIC)
SECTION 12 Location to Location Transfer: (Bars and Liquor Stores,ONLY)
APPLICANTS CANNOT OPERATE UNDER A LOCATION TRANSFER UNTIL IT IS APPROVED BY THE STATE 7 L I Q L I C
Current Business Name and Address:
(Exactly as it appears on license)
2. New Business Name and Address:
(Do not use PO Box Number)
3. License Type:
4. What date do you plan to move?
Number:
Questions for all in -state applicants:
1. Distance to nearest school: lX
(Regardless of distance)
2. Distance to nearest church: OlJ ft.
(Regardless of distance)
Last Renewal Date:
What date do you plan to open?
Name/Address of school: jr6i /Aiz 4 h � L�,5_C4-11
Name/Address of church: i
am the: ❑ LESSEE ❑ SUBLESSEE �OwNER
If the premises is ]eased give lessors name and address:
Q�- Monthly rental/lease rate $
2 e5- ZI; p
❑ PURCHASER (of premises)
What is the remaining length of the lease? yrs. mos.
What is the penalty if the lease is not fulfilled? $ or other
(give details - attach additional
sheet if necessary)
5� Vhat is the total business indebtedness of the applicant for this license/location excluding lease? $
Does anyone creditor represent more than 10% of that sum? ❑ YES 7 NO If yes, list below. Total must equal 100%.
Last Fast Middle % Owed Residence Address City State Zip
(ATTACH ADDITIONAL SHEET IF NECESSARY)
6�What type of business will this license be used for? (BE SPECIFIC)r _ I Z_
7 . Has a licen , or a transfer license for the premises on this application been denied by the state within the past one (1) year?
17 YES 1 NO If yes, attach explanation.
oes any spirituous liquor manufacturer, wholesaler, or employee, ave any interest in your business? ❑YES`�NO
9. Is the premises currently licensed with a liquor license? ❑ YES NO If yes, give license number and licensee's name:
License # (Exactly as it appears on license) Name
ZECT:10=N_14k staurant, or Hotel -Motel Applicants:
1. Is there a valid restaurant or hotel -motel license at the proposed location? ❑ YES IdNO If yes, give licensee's name:
' 'and eekshQ#:
Last
Fast
Middle
2. If the answer to Question 1 is YES, you may qualify for an Interim PeruWc&rat8l4ery L4Mplication is pending; consult
A.R.S. Section 4-203.01; and complete Section 5 of this application.�� ff II ((jj�J
3. All restaurant applicants must complete a Restaurant Operation Plan (Form LIC0114) provided by the Department of Liquor.
4. Do you understand that 40% of your annual gross revenue must be from food sales?'gYES ❑ NO
SE ION 15 D gram of Premises: (Blueprints not accepted, diagram must be on this form)
1. Check ALL boxes that apply to your licensed premises:
JR Entrances/Exits Liquor storage areas
❑ Drive-in windows Patio enclosures
❑ Service windows ❑ Under construction: estimated completion date
2. Restaurants and Hotel/Motel applicants must explicitly depict kitchen equipment and dining facilities.
3. The diagram below is the only area where spirituous liquor is to be sold, served, consumed, dispensed, possessed, or stored.
Give the square footage or outside dimensions of the licensed premises.
DO NOT INCLUDE PARKING LOTS, LIVING QUARTERS, ETC.
t ,.'K_
YOU MUST NOTIFY THE DEPARTMENT OF LIQUOR OF ANY CHANGES OF BOUNDARIES, ENTRANCES,
EXITS, OR SERVICE WINDOWS MADE AFTER SUBMISSION OF THIS DIAGRAM.
"CTIONGeographical Data: A SAMPLE FOR THIS SECTION I§ PROYIDQ�i ON THE BACK OF THIS PAGE.
F'� a
;st below the exact names of all churches, schools, and spirituous liquor outlets within a one h adius of your proposed location.
1. I�ad
2.
3.
4. d Gt /� �� 0 f ,g
5.
6. All
7. JV et,l.%1 e�j✓ CyGi�'C
(WrACH ADDITIONAL SHEET IF NECESSARY)
A = Your business name and identify cross streets.
CTION 1 ignature Block:
r
declare that: 1) I am the APPLICANT (Agent/Club Member/Partner , makingthis
(Prue name of APPLICANT/AGENT listed in Section 4 Question 1) )
application; 2)1 have read the application and the contents and all statements are true, correct and complete; 3) that this application is not being
made to defraud or injure any creditor, taxing authority, regulatory authority, or transferor; 4) that no other person, firm, or corporation, except
as indicated, has an interest in the spirituous liquor license for which these statements are made; and 5) that none of the owners, partners,
members, officers, directors or stockholders listed have been convicted of a felony in the past five (5) years.
State of 00Vv County of ` U
X G The foregoing instrument was acknowledged before me this
0" da
MRAWA MORIN Day of Month y of Mont _e.
NOTARY /RNUO - AtliONACPA
My commissio
(SiwaWof NOTAR)�PXJBLIC) /
7
SAMPLE
GEOGRAPHICAL, ATA
LIQ L/C
In the area adjacent to the map providedJ0Q?pw d�ates your proposed locati<
and the exact names of all churches, schools, a`n'cWolic beverage outlets
within a 1/2 mile radius of your proposed location.
(See example below)
licant
Series 12
01 Pink Elephants Series 06
02 Mama's Rest.
Series 12
03 Corner Liquors Series 09
04 Joe's Groceries Series 10
05 Lions Club Series 14
06 Burgers R Us Series 07
07 Pizza Perfect Series 07
08 Billy Bobs Bar Series 06
09 St. Anthonys Church
10 St. Anthonys School
11 Burbank Middle School
12 First United Baptist Church
13
1
15
A.R.S. Section 4-207.A reads as follows:
Mi.
Mi.
Mi.
Y2 M i .
A. No retailers license shall be issued for any premises which are. at the time
the license application is received by the Director, within three hundred(300)
horizontal feet of a church, within three hundred(300) horizontal feet of a
public or private school building with kinderga t nrnqr any of
grades one(1) through twelve(12). or within thre ti �'� 00 :horizontal
feet of a fenced recreational area adjacent to L2-1-s;,cheffITO�b ilding.
v r01,�') AyCI?"'
i
Fountain Hills Street Map-10- LIC
Ju"I 25 3 1, r
Ile
ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL
800 W Washington 5th Floor 4 ' L1 Q LI C 400 W Congress #150
Phoenix AZ 85007-2934 Tucson AZ 85701-1352
kla.,. (602) 542-5141 *JUN 25 3- 115 PH :01(520) 628-6595
RESTAURANT OPERATION PLAN
LICENSE #
1. List by Make, Model and Capacity of your
Grill
Oven
2 5e,&f f4 I �eir
Freezer
Refrigerator
2
Sink
Dish Washing
Facilities
G i ef
12
r7
Food Preparation
Counter (Dimensions)
0 ' , L (`
/ f l�°lY
Other
2. Print the name of your restaurant: t o �/d /A" /Y hul z eoy
3. Attach a copy of your menu (Breakfast, Lunch and Dinner including prices).
4. List the seating capacity for:
a. Restaurant area of your premises [ 700
]
b. Bar area of your premises [ + ]
C. Total area of your premises [ 330
]
5. What type of dinnerware and utensils are utilized within your restaurant?
Reusable ❑ Disposable
6. Does your restaurant have a bar area that is distinct and separate from the restaurant seating? (If yes, what
percentage of the public floor space does this area cover). L t Yes f o % ❑ No
What percentage of your public premises is used primarily for restaurant dining?
(Does not include kitchen, bar, cocktail tables or game area.) � C) %
*Disabled individuals requiring special accommodations, please call the Department.
Uc0114 0511999
8. Does your restaurant Contain any games or television? '4l ❑ Y9'No
(If yes, what types and how many? Pool tables, Video Games, DA0, e Q
4$ PU o
9. Do you have live entertainment or dancing? ❑ Yes`�No
(If yes, what type and how often?) ///
10. Use space below or attach a list of employee positions and their duties to fully staff your business.
� /7
hereby declare that I am the APPLICANT filing this application. I have
(Print full name)
read theis application and the contents and all statements true, correct and complete.
(Signature of APPLICANT)
State of County of
The foregoing instrument was acknowledged before me this
Day of Month
day of
Month Year
My commission expires on::
(Signature of NOTARY PUBLIC)
8, oes your restaurant Contain any games or television? ❑ Yes ❑
es, what types and how many? Pool tables, Video Games, Darts, etc.) z
AZ L10 LIC
9. Do you have live ent�
(If yes, what type and
neat or dancing?
often?)
10. Use space below or attach a list of
try
hrYes ❑ No
R_�
and their duties to fully staff your business.
I, X / Q hereby declare that I am the APPLICANT filing this application. I have
(Print full name)
read theis application and the contents and all statements true, correct and complete.
State of County of
X The foregoing instrument was acknowledged before me this
(Si ature of APPLICANT) ` >ZA
�V day of
Day of Month Year
My commission expires on::
(Sign e of NOTARY PLBLIQ
aFF'Cia. seas
�(IMBERLY R MMEAL
I5'` NOTARY P UBLIC •ARIZONq
Co ARICOPA COUNTY
Y mm. Expires July 30, 2002
2
800 W Washington Sth Floor
Phoenix AZ 85007-2934
(602)542-5141
ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL
400 W Congress #150
A `7 L I'�c P3628 01- 352
QUESTIONNAIRE
.�,ACIAL SECURITY AND BIRTHRATE INFORMATIONA132CONFIDEWAL BY LAW
AND CANNOT BE DISSEMINATED TO THE PUBLIC
rceau k am uuy , uus instrument is a sworn document. Type or print with black ink
An extensive investigation of your background will be conducted. False or incomplete answers could result
in criminal prosecution and the denial or subsequent revocation of a license or permit.
CO BE COMPLETED BY EACH OWNER AGENT, PARTNER, STOCKHOLDER (10% OR MORE), MEMBER, OFFICER OR MANAGER ALSO EACH PERSON
'OMPLETING THIS FORM MUST SUBMIT AN "APPLICANT' TYPE FINGERPRINT CARD WHICH MAY BE OBTAINED AT THE DEPT. FINGERPRINTING MUST BE
)ONE BY A BONA FIDE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVICE APPROVED BY THE DEPARTMENT OF LIQUOR THE DEPARTMENT
)OES NOT PROVIDE THIS SERVICE.
Check
appropriate
box ---,
There is a $24.00 Processing fee for each fingerprint card submitted.^ /gyp
A service fee of $25.00 will be charged for all dishonored checks (AILS. 44.6852) Ir� l I O6 0 icy
❑Owner ❑Partner ❑Stockholder ❑Member ❑Officer ❑ Agent Manager(Only)
❑ Other (Complete Questions 1-20 & 24) Complete All Questions except # 14,14a & 25)
Licensee or Agent must complete # 25 for a Manager Licensee or A ent must complete # 25
y6 ljl� nZ&� .t
D
. Name: ate of Birth:.._ � - / ^��
Last Fit 7Mfid°dle (This Will t Become a Part of Public Records)
Social Security Number: iDrivers License #:_-T / (� _ State: )�' Z-
(This Will Not Become a Part of Public Records) %—
Place of Birth: Height: Weight: - 2 4 Eyes: &tie Hair:
State �C
City `wiry .
Marital Status ❑ Single ❑ Married (Divorced ❑ Widowed 60A
Residence (Home) Phone: Q20i �of Current or Most Recent Spouse: 6 L �G i/% 1' A /Y! Date of Birth: � i -S3
;ist for last 5 years - Use additiotiA sheet if necessary) Last First Middle Maiden ('
You are a bona fide resident of what state? —Tu,/ � If Arizona, date of residency: � 3c� - ,1'_
Telephone number to contact you during business hours for any questions regarding this document. (we o d /
If you have been a resident less than three (3) months, submit a copy of driver's license or voter registration card. /
). Name of Licensed Premises: �7 ,�i� !� J 1✓ !//C1,/remises Phone: �o-L---�
1. Licensed Premises Address: r � i✓G/L /" i�i/y� ,r✓/� L G
,� Liquor License #
Street ess (Do not use PO Box #) Cky pf($r C0unty/f6 fj4 / Z (If this location is currently licensed)
2. List your employment or type of business during the past five (5) years, if unemployed part of the time, list those dates_ List most recent ist_
FROM
Month/Year
TO
Month/Year
DESCRIBE POSITION
OR BUSINESS
EMPLOYER'S NAME OR NAME OF BUSINESS
(Give street address, city, state & zip)
CURRENT
a t
ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION
S. Indicate your residence address for the last five (5) years:
FROM
Month/Year
TO
Month/Year
RESIDENCE
Street Address
Cltv
State
Zi
jj ' d J
3G r9��>,�� ���9 r- �sZ tr �z
,cs�d
-
IO-2-
j's2
[ 1 1 . /20 Dtsabled uxaviduals requiring special accommodations please call (6 2) 542-9051
you checked the Manalzer box on the front of this form skip to # 15
L. As an Owner, Agent, Partner, Stockholder, Member or Officer, will you be physically present and operating YES LINOT
the licensed premises ? If you answered YES, how many hrs/day?, answer #14a below. If NO, skip to #15.
4. Have you attended a Department approved Liquor Law T=aipip ourse within the last 5 years? (Must provide proof) [2 YES ❑ NO
If the answer to # 14a is "NO", course must be completed > gft&uance of a new license or approval on an existinL- license.
Have you EVER been detained cited, arrester
ordinance (regardless of the disposition even if
those that were alcohol and/or drug related
into court for violation of ANY law or
Have you EVER been convicted, fined, Hosted bond been ordered to deposit bail, imprisoned. had sentence
suspended. -laced on probation or parole for violation of ANY law or ordinance (regardless of the disposition
even if dismissed or expunged)? For traffic violations, include only those that were alcohol and/or drug related.
Are there ANY administrative law citations, compliance actions or consents, criminal arrests, indictments or
summonses PENDING against you or ANY entity in which you are now involved?
Have you or any entity in which you have held ownership, been an officer, member, director or manager EVER
had a business, professional or liquor APPLICATION OR LICENSE rejected, denied revoked suspended or
ned in this or any other state?
�. Has anyone EVER filed suit or obtained a iudgment against you in a civil action, the subject of which
involved fraud or misrepresentation of a business, professional or liquor license?
). Are you NOW or have you EVER held ownership, been a controlling person , been an officer, member, director,
or manager on any other liquor license in this or any other state?
❑ YES D$NO
DYES [ENO
El YES 2 NO
YES ❑ NO
f any answer to Questions 15 through 20 is "YES" YOU MUST attach a signed statement giving complete details._
Please be sure to include dates, agencies involved and dispositions.
you checked the Manager box on the front of this form, fill in #21-23 and 24, all others skip the following box (21-23) and go to # 24
Manager Section
21. Have you attended a Department approved Liquor Law Training Course within the last 5 years? (Must provide proof) 9 YES ❑ NO
If the answer to #21 is "NO" course must be completed BEFORE ISSUANCE of a new license OR APPROVAL on an existing license.
22. Do you make payments to the licensee? ❑ YES ❑ NO If "yes", how much? $ per month. Total debt to licensee $
23. Is there a formal written contract or agreement between you and the licensee relating to the operation or management of this business?
❑ YES 0 NO If `yes", attach a copy of such agreement
hereby declare that I am the APPLICANT filing this questionnaire.
(Print full name of AppY=)
have read this questionnaire and the contents and all statements are true, correct and complete.
a aALsit State of (it/li/LO County of Old
v �i E3ER4. N The foregoing instrument was acknowledged before me this
(Sipawm o ; oA NOTARY PUBLIC
MARICOPA COUNTY �O
My Comm. Expires July 30, 2002 day of
l Day ofMmth Month Year
ly commission expires on: '7 — 3w — o :-
Day of Month Month Year
of NOTARY PUBLIC)
FILL IN 'PHIS SECTION ONLY IF YOU ARE A LICENSEE OR AGENT APPROVING A MANAGER APPLICATION
Licensee or Agent Approval of Manager
25. I, (Print Licensee/Agent's Name): '
il Last
Hereby authorize the applicant to act as manager for the named liquor license.
(Signature of LIMNSEE/AGENT)
My commission expires on: —7 f 3 v D 2
Day of March Month Year
Middle
First
�i2 r
State of chlf ZOO Q e County of
The foregoing instrument was acknowledged before me tSis
1sy�—day of ,
Day of Month Year
w,
`? MARICOPA COUNTY
• s; My Comm. Expires July 30, 2002
.�. +..y�q�r���'ti'T"►i,�i�"!�:":+' 'f _fir►�
E:' LIf! 1.1C
! Z5 Pill '01
8 683 808
mr... -.ale..--
:yr�//ia�i��aG•/rJ,%c� /�:/.�//•lwill/ii�ir/irr/ri�i:•�11i�� it/�—.rigp_l,._19, 53 ----- -- _..-�`r1 2- - - . /Jic
�011iJI1/�iZM�I� /J!//I/7!/•JY 9///./!�.1.._ iIOl�E_�� rT� -
(JGY/Jill% t B.l�_ _ -•_• _ _-._ST-_ .._
i/,✓Cn•/1/�•.c/%/�'r�%i�»;!!I'nfY �//�C'J/ Lf //Y!/.; /I'!/IJ�I�!/!.'.lsii,�ir1t Jn�i/.��Jrr//rir•/a.c� /i• / ,�JJr.Jr.•fI
EASTERN f>,!•/i•uJr//+r//rsi./Jin/iir•/,/%r/�!!/ir/-
DISTRICT or MICI ITGAN rs:
SOUrl-IS.f� !/�J d DIVISION _ - ) .
rrs''i7te�Wrf
IJnite�d
Detroit
y.
.'4• '1 ��/G+1I/r�G''ll7/?d�'�%-•-�_�i`� Z'O�.L + �`!,d't!Lll�j
,Ax!//llrnD� .1!/mJ. nalu�r' r.J/lam firu:� err!/• �vn,/�»/t!! i
JYtrG9lY/•11irG' ac/f �J/'
/
1r. t,%�i,•c�llac�d��i / e>�vs�r � . � : �3
;47t�►�N/�l/�ala�x1l�xs!./��
� � .j � 4.4,ipk24t.: • .JfA(r1'YfiiiYN•`l0!'cc�vr�ltC/cefr���Ju'Jt
Cj
�/!l�(�i: C�lIO1Ili tJ�t!><1f�11t - ...... U_S. DistriC�G/l/Nir•
ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL
800 W Washington 5th Floor 400 W Congress #150
Phoenix AZ 85007-2934 0- [; 1 4 (� Tucson AZ 85701-1352
(602) 542-5141 QUESTIONNAIRE (520) 628-6595
.,,OCIAL SECURITY AND BIRTHDATE INFORM lift fs,,-,;c6WhDENT1AL BY LAW
AND CANNOT BE DISSEMINATED TO THE PUBLIC
Read Carefully, this instrument is a sworn document. Type or print with black ink
An extensive investigation of your background will be conducted. False or incomplete answers could result
in criminal prosecution and the denial or subsequent revocation of a license or permit.
CO BE COMPLETED BY EACH OWNER, AGENT, PARTNER, STOCKHOLDER (10% OR MORE), MEMBER, OFFICER OR MANAGER. ALSO EACH PERSON
'OMPLETING THIS FORM MUST SUBMIT AN "APPLICANT' TYPE FINGERPRINT CARD WHICH MAY BE OBTAINED AT THE DEPT. FINGERPRINTING MUST BE
)ONE BY A BONA FIDE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVICE APPROVED BY THE DEPARTMENT OF LIQUOR THE DEPARTMENT
)OES NOT PROVIDE THIS SERVICE.
There is a $24.00 processing fee for each fingerprint card submitted I j� A
V
1L
A service fee of $25.00 will be charged for all dishonored checks (AS. 44.6852) (J
heck
ppropriate
box —,
❑Owner ❑Partner ❑Stockholder ❑Member ❑Officer ❑ Agent ❑ Manager(Only)
❑ Other (Complete Questions 1-20 & 24) Complete All Questions extent # 14,14a & 25)
Licensee or Agent must complete # 25 for a Manager Licensee or Agent must complete # 25
Name: lei' Tti tEEJ Date of Birth: ('`11 if1-,_q I-
Last First Middle (This Will Not Become a Part of Pub Records)
Social Security Number:. 5 2-,-�3 6 -2 5 3 ` Drivers License #: 9C'j 624� Q- State: _A ZE&-,R Xs;K4
(This Will Not Become a Part of Public Records)
Place of Birth: Rf-►J�1f` yyyA, l CI�Y+i46 c Height: O � Weight: � Eyes: �_ Hair: _
City State Country
Marital Status ❑ Single 54 Married ❑ Divorced ❑ Widowed Residence ((Home) Phone:: (4602 J Q�_
of Current! �
or Most Recent Spouse: R E�L--�f)YCZ Z,, A81�Y 16 Al✓V Date of Birth:
ist or last 5 years - Use additio t,d sheet if necessary) Last First Middle Maiden 1 —�
You are a bona fide resident of what state? r 1re'R If Arizona, date of residency:
Telephone number to contact you during business hours for any questions regarding this document. 1 C130
If you have been a resident less than three (3) months, submit a copy of driver's license or voter registration card.
). Name of Licensed Premises: r Premises Phone: (y4 l
1. Licensed Premises Address: " lrA P, 4Z 15Z 6%3 Liquor License #
Street Address (Do no use PO Box #) 0 County Zip Q (If this location is currently licensed)
2. List our ent to ent or e of business duringthe past five (5) years, s� 1 e art of dhe time, list those dates. List most recent 1st
FROM
Monrb/Year
TO
Month/Year
DESCRIBE POSITION
OR BUSINESS
EMPLOYER'S NAME OR NA VIE OF BUSINESS
(Give street address, city, state & zip)
CURRENT
c 9 —SAPP BeLs
ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECTION
4. Indicate your residence address for the last five (5) years:
FROM
Mcnth/Year
TO
Month/Year
RESIDENCE
Street Address
City
State
Zi
C `' n
CURRENT
I
pe-
ice, vlvi vvw voauicu uuvnuuats requwurg spmnu a"uuunuuauuus picaw can kouz) zqz-yubi
to
As an Owner, Agent, Partner, Stockholder, Member or Officer, will you be physically present and operating LJ Yhs QdlVv
the licensed premises ? If you answered YES, how many hrs/day? , answer #14a below. If NO, skip to #15. //
i. Have you attended a Department approved Liquor Law Training Course within the last 5 years? (Must provide proof) ❑ YES 2 NO
If the answer to # 14a is "NO", course must be completed before issuance of a new license or approval on an existing license.
Have you EVER been detained cited, arrested, indicted or summoned into cot fbr violation of ANY law or
ordinance (regardless of the disposition even if dismissed or exylungy� )? For traffic violations include only
those that were alcohol and/or drug related. �Ud L j 45 l/ imprisoned, had sentence pt] Io +
Have you EVER been convicted fined, bond been ordered to deposit bail imprisoned had sentence
been ordered to deposit bail,
suspended, on probation oryaroleonprobation oryarole _ for violation of ANY law or ordinance (regardless of the disposition
even if dismissed or expunged)? For traffic violations include only those that were alcohol and/or drug related.
Are there ANY administrative law citations, compliance actions or consents, criminal arrests, indictments or
summonses PENDING against you or ANY entity in which you are now involved?
Have you or any entity in which you have held ownership, been an officer, member, director or manager EVER
had a business, professional or liquor APPLICATION OR LICENSE reiected denied revoked, suspended or
.fired in this or any other state?
Has anyone EVERfiled suit or obtained a judgment against you in a civil action, the subject of which
involved fraud or misrepresentation of a business professional or liquor license?
Are you NOW or have you EVER held ownership, been a controlling persQn.,Ibeen an officer, member, director,
or manager on any other liquor license in this or any other state?
❑ YES wNO
❑ YES VNO
❑ YES "0
❑ YES "0
❑ YES VNO
Fany answer to Questions IS through 20 is "YES" YOU MUST attach a signed statement giving complete details._
you checked the Manager box on the front of this form, fill in #21-23 and 24, all others skip the following box (21-23) and go to # 24
Manager Section
? 1. Have you attended a Department approved Liquor Law Training Course within the last 5 years? (Must provide proof) ❑ YES. ❑ NO
If the answer to #21 is "NO" course must be completed BEFORE ISSUANCE of a new license OR APPROVAL on an existing license.
22. Do you make payments to the licensee? ❑ YES ❑ NO If "yes", how much? $ per month. Total debt to licensee $
?3. Is there a formal written contract or agreement between you and the licensee relating to the operation or management of this business?
❑ YES ❑ NO If "yes", attach a copy of such agreement
F1
i. I, ICI F,r�rvtA —t; Rrl= y-L t , hereby declare that I am the APPLICANT filing this questionnaire.
(Print full name of Applicant)
lave read this questionnaire and the contents and all statements are true, correct and complete.
State of N� S l; >a Countyof
The foregoing instrument was acknowledged before me this
(Simature of App
_ i Q day of
Day of Month Mo GENERAL NOTARY•Stati of Nebraska
du WILLIAM A. CR0�1 T 1,1)
ly commission expires on: —
Day of Month Month Year (Signature o OTARY PUB
FILL IN THIS SECTION ONLY IF YOU ARE A LICENSEE OR AGENT APPROVING A MANAGER APPLICATION
Licensee or Agent A�_of Manager
25. I, Print Licensee/Agent's Name):
Last Middle First
Hereby authorize the applicant to act as manager for the named liquor license.
(Signature of 1ICENSEE/AGEN1)
My commission expires on:
Day of Mornh Month
Year
State of County of
The foregoing instrument was acknowledged before me this
day of
Day of Month Month
(Signanse of NOTARY PUBLIC)
Year
ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL
800 W Washington 5th Floor 400 W Congress #150
Phoenix AZ 85007-2934 Tucson AZ 85701-1352
(602) 542-5141 QUESTIONNAIRE AZ L i 0- L i C (520) 628-6595
SOCIAL SECURITY AND BIRTHDATE INFORMATION IS CONFIDENTIAL BY
AND CANNOT BE DISSEMINAT T-Ht NALic
Read Carefully, this instrument is a sworn document. Type or print with black ink
An extensive investigation of your background will be conducted. False or incomplete answers could result
in criminal prosecution and the denial or subsequent revocation of a license or permit.
TO BE COMPLETED BY EACH OWNER AGENT, PARTNER STOCKHOLDER (10% OR MORE), IVIEN1BER, OFFICER OR MANAGER ALSO EACH PERSON
COMPLETING THIS FORM MUST SUBMIT AN ".4PPLICAXr' TYPE FINGERPRINT CARD WHICH MAY BE OBTAINED AT THE DEPT. FINGERPRINTING MUST BE
DOME BY A BONA FIDE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVICE APPROVED BY THE DEPARTMENT OF LIQUOR THE DEPARTMENT
DOES NOT PROVIDE THIS SERVICE.
1. Check
appropriate
box —001.
There is a $24 00 processing fee for each fingerprint card submitted !�
A service fee of $25.00 will be charged for all dishonored checks (AILS. 44.6852) I f \ 5L)
❑Owner []Partner []Stockholder Member ❑Officer ❑ Agent ❑liana er O
t g (nl y)
❑ Other (Complete Questions 1-20 & 24) Complete All Questions except # 14,14a & 25)
Licensee or Agent must complete # 25 for a Manager Licensee or Agent must complete # 25
2. Name: s eA o W i 'I j7e a L, Date of Birth: / 2- Z (o .3 7
Last Fast Middle (This Will Not Become a Part of Public Records)
3 . Social Security Number: y7ff - 1/0 - / % // Drivers License #: G O 10 7,g 6 Z- Stater i!a sic a
(This Will Not Become a Part of Public Records)
I/� /c
4 . Place of Birth: ov ccllec ( (�(�c ��5 ot�;� 14. tT Height: /O Weight: Z7- Eyes: ff-/-!�- Hair: RlcP
City State Country
5. Marital Status ❑ Single ZMarried ❑ Divorced ❑ Widowed Residence (Home) Phone: (&-OIL
"-rnie of Current or Most Recent Spouse: Scf 4 f, e ti r +,1 G - at, t N e 4, �Me I- Date of Birth:
I%Wa for last 5 years - Use additim%il sheet if necessary) Last J First Middle Maims
You are a bona.fide resident of what state? _ N P_ 6 tr d s k 2- If Arizona, date of residency:
8 Telephone number to contact you during business hours for any questions regarding this document. (!Lo�) 1?9 _- -�'-3?
9. If you have been a resident less than three (3) months,, submit a copy of driver's license or voter registration card.
10. Name of Licensed Premises: 6/.(1i/ '�?, / LOlC- 01 Z-? Premises Phone: 6 _ 500
n rn
11. Licensed Premises Address: ��G1A!/,0>%N Ili d; w /�'rYed E- �' /YI/iWl��r ,►�S>. 1,1"T '
12. List your employment ortk
t�Addrreess'y((D�o noc use PO Box #) City County
the pact hives (51 vaZip
C/Fft 15f� Ind Lrlun/iL�
nes. t PF arc ,f nnamnlnvaJi nary f rF,a y o
aquor License #
(If this location is currently licensed)
SCIIe,�tzip)
�y se, tes.:,
t�NAY[EK�FB J F S�' 1
4l
FROM
TO
DESCRIBE POSITION
EMPLOYER'S NAMEO
Month/Year
Montb/Year
OR BUSINESS
(Give street address, pryt
ATTACH ADDITIONAL SHEET IF NECESSARY FOR EITHER SECITON
13. Indicate your residence address for the last five (5) years:
FROM TO RESIDENCE
Month/Year Month/Year StreetAddressCicv State Zi
T D CURRENT O O .` _ /`t 7� _ O�7
i
I
-- ul IULUM3 1-Cqu" ULK JtJCLl 4ll:W"Mu"Llull.1 JACUbc Lam kDUZJ Z4Z W51
-- ul IULUM3 1-Cqu" ULK JtJCLl 4ll:W"Mu"Llull.1 JACUbc Lam kDUZJ Z4Z W51
you checked the Manager box on the front of this form sadi to # 15
4. As an Owner, Agent, Parmer, Stockholder, Member or Officer, will you be physically present and operating
L7 YES XNO
the licensed premises ? If you answered YES, how many hrs/day? , answer #14a below. If NO, slap to #15.
4a. Have you attended a Department approved Liquor Law Tt it in course within the last 5 years? Must provide proof)
❑ YES ❑ NO
If the answer to # 14a is "NO", course must be completed erd.i.�ance of a new license or approval on an existing license.
5. Have you EVER been detained, cite arrested,ind sum oned into court for violation of ANY law or
❑YESNO
ordinance (regardless of the disposition even if dismt d expullcoiiirlaffuc violations, include only
those that were alcohol andlor drug related
6. Have you EVER been convicted, fined posted bond been ordered to deposit bai4 imprisoned, had sentence
❑ YES J%NO
suspended placed on probation or parole for violation of ANL y law or ordinance (regardless of the disposition
even if dismissed or expunged)? For traffic violations include only those that were alcohol andlor drug related.
17. Are there ANY administrative law citations, compliance actions or consents, criminal arrests, indictments or
Cl YES )d NO
summonses PENDING against you or ANY entity in which you are now involved?
13. Have you or any entity in which you have held ownership, been an officer, member, director or manager EVER
❑ YES X NO
bad a business, professional or liquor APPLICATION OR LICENSE reiected denied revoked, suspended or
_flned in this or any other state?
19. Has anyone EVER filed suit or obtained a iudement against you in a civil action, the subject of which
❑ YES X NO
involved fraud or misrepresentation of a business professional or liquor license?
20. Are you NOW or have you EVER held ownership, been a controlling person , been an officer, member, director,
YES ❑ NO
or manager on any other lgquor license in this or any other state?
If any answer to Questions 15 through 20 is "YES" YOU MUST attach a signed statement
nr, --- r.,. .._ . .�.,.t,..t 4-Ze aaonr;oc involved and dispositions.
giving complete details._
If you checked the Manager box on the front of this form, fill in #21-23 and 24, all others skip the following box (21-23) and go to # 24
Manager Section
21. Have you attended a Department approved Liquor Law Training Course within the last 5 years? (Must provide proof) ❑ YES ❑ NO
If the answer to #21 is "NO" course must be completed BEFORE ISSUANCE of a new license OR APPROVAL on an existing license.
22. Do you make payments to the licensee? ❑ YES ❑ NO If `oyes", how much? $ per month. Total debt to licensee $
23. Is there a formal written contract or agreement between you and the licensee relating to the operation or management of this business?
❑ YES ❑ NO If `yes", attach a copy of such agreement
24 I, 2 J t Ln . 5G /o 14 r sq c hereby declare that I am the APPLICANT filing this questionnaire.
(Print full na= of Applicant) 13
I have read this questionnaire and the contents and all statements are true, correct and complete.
TEAM L TEFFT
My Comm. Up. Apnt 5, 2004
My commission expires on:
T1o., nF T�f�nrh M—h Yrnr
State of "6cr.) -ia Countyof
The foregoing instrument was acknowledged before me this
/,? day of =L u. e 0 a 1 .
Day of Mooch Mooch y—
(Sign=e of NOTARY PUBLIC)
FILL IN THIS SECTION ONLY IF YOU ARE A LICENSEE OR AGENT APPROVING A MANAGER APPLICATION
Licensee or Agent Approval of Manager
25. I, Print Licensee/Agent's Name):
Last
Hereby authorize the applicant to act as manager for the named liquor license.
(Sipau= of L.ICENSEEIAGL-M
?vTy commission expires on:
Day of Morah Moorh Year
Middle
Fast
State of County of
The foregoing instrument was acknowledged before me this
day of
Day or Moafh Mooch Ym
(Sip =ze of NOTARY PUBLIC)
AZ LIC LIC
full 25 3
TO WHOM IT MAY CONCERN:
June 18, 2001
Re: Question 20 - Arizona Department of Liquor
Licenses & Control Questionnaire
The undersigned was a 60% owner in "Pleasure Enterprises, Inc.", an entity that held a
Nebraska liquor license and operated the `Skylanes Bowling Center' and `Cimarron
Room Restaurant' at 42" d and Center Streets in Omaha, Nebraska from 6/1/85 through
5/31/97. Pleasure Enterprises, Inc. discontinued all business operations as of May 31,
1997.
, v e e - e-
Edwin D. Schoening
ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL
800 W Washington 5th Floor 400 W Congress #150
Phoenix AZ 85007-2934 0
"Z Tucson
01- 352
(602) 542-5141 QUESTIONNAIRE 1 (520 628 6
IAL SECURITY AND BIRTHDA
0
AND CANNOT BE DISSEMINATED TO T
DENTIAL BY LAW
Read Carefully, this instrument is a sworn document. Type or print with black ink
An extensive investigation of your background will be conducted. False or incomplete answers could result
in criminal prosecution and the denial or subsequent revocation of a license or permit.
TO BE COMPLETED BY EACH OWNER, AGENT, PARTNER, STOCKHOLDER (1017, OR MORE), MEMBER, OFFICER OR MANAGER ALSO EACH PERSON
COMPLETING THIS FORM MUST SUBMIT AN "APPLICANT' TYPE FINGERPRINT CARD WHICH MAY BE OBTAINED AT THE DEPT. FINGERPRINTING MUST BE
DONE BY A BONA FIDE LAW ENFORCEMENT AGENCY OR A FINGERPRINTING SERVICE APPROVED BY THE DEPARTMENT OF LIQUOR THE DEPARTMENT
DOES NOT PROVIDE THIS SERVICE.
There is a $24.00 processing fee for each fingerprint card submitted
A service fee of $25.00 will be charged for all dishonored checks (AILS. 44.6852) I _/
1. Check
appropriate
box —,
❑Owner ❑Partner ❑Stockholder ember ❑Officer ❑ Agent ❑ Manager(Only)
❑ Other (Complete Questions 1-20 & 24) Complete All Questions except # 14,14a & 2-9)
Licensee or A ent must complete # 25 for a Manager Licensee or Agent must complete # 25
2. Name: Vice I C f ix k P Date of Birth: %- /o - A 5-
List Last v Fist Middle (This Will Not Become a Part of Public Records)
3. Social Security Number: S0 %— /y— 9S/65—Drivers License #: C O 13 JI1 9 S1 State: zt e k v-1s Gr
(This Will Not Become a Part of Public Records)
4. Place of Birth: Dtyt a a �. �� t (r u �'
J�% Ia S Height: — Weight: f_ Eyes:( Hair:
City State Country
5. Marital Status ❑ Single ® Married ❑ Divorced ❑ Widowed Residence (Home) Phone: ( ) 9 /
6 mie of Current or Most Recent Spouse: t<L- e r �+ i Ve Ira n s^ r 4 47 r
(�f for last 5 yeanecessary) years - Use additional sheet if -� �— Date of Birth: ?-! 7- 3 %
.Last First Middle Maiden
You are a bona fide resident of what state? /V e— �--a.15 & a If Arizona, date of residency:
8 Telephone number to contact you during business hours for any questions regarding this document. (Yp�j -1/ 93 - 6 1 gam_
9. If you have been a resident less than three (3) months, submit a copy of driver's license or voter registration card.
10. Name of Licensed Premises: > C�� % , � 64-1 V/ 15W (�` L L G /' Premises Phone:
11. Licensed Premises Address:-r[ i� �, �' /L% D ��/��/f��� Liquor License #
��>>Street AdFiid�hng
(Do not usye�PO Box #) City Cl County Zap (If this location is currently licensed)
12. List our employment or to 4�' � r�a� F f G� ytyp 0 usuneS the t the (5) vears. t unemnlnverl Harr of t e time Fer t-1— o- 4.,.— -T
FROM
Month/Year
TO
Month/Year
DESCRIBE POSITION
OR BUSINESS
u,.,— ualw. i.ul ulwalCl;ett�_t.
EMPLOYER'S NAME OR N- A�OF_BISIlYFSS
(Give street address, city, stite & up)
-
CURRENT
rA
ATTACH ADDITIONAL SHEET IFNECESSARY FOR EYIHER SECTION
13. Indicate your residence address for the last five (5) veare-
FROM
Month/Year
i
TO
Mcnth/Year
- - --- RESIDENCE
Street Address
City State Zi
CURRENT
3 2 0 0 ! S e
Yuuas�——VIULIUA 1 VqLib JFltlliil i1l.l.VLL11VUd11U1Z yi CabC l.:Ul tOV:.I -�y:,-yMl
you checked the Manager box on the front of this form skip to # 15
14. As an Owner, Agent, Partner, Stockholder, Member or Officer, will you be physically present and operating YES NO
the licensed premises ? If you answered YES, how many hrs/day? , answer #14a below. If NO, skip to #15.
f4a. Have you attended a Department approved Liquor Law Training Course within the last 5tesars (Must provide proof) El YES El NO
If the answer to # 14a is "NO", course must be completed before issuance of a new`T1eeose-pr approval on an existing license.
! 5. Have you EVER been detained cited arrested indicted or summoned into couttjOr114Dlation of ANY law or ❑YES XNO
ordinance (regardless of the disposition even if dismissed or expunged)? For tra v lati t- 'ncI a onl
those that were alcohol and/or drug related
16. Have you EVER been convicted, fined posted bond been ordered to deposit bail, imprisoned. had sentence ❑ YES ;(NO
suspended placed on probation or parole for violation of ANY law or ordinance (regardless of the disposition
even if dismissed or expunged)? For traffic violations include only those that were alcohol and/or drug related.
17. Are there ANY administrative law citations, compliance actions or consents, criminal arrests, indictments or ❑ YES 9NO
summonses PENDING against you or ANY entity in which you are now involved?
(.8. Have you or any entity in which you have held ownership, been an officer, member, director or manager EVER ❑ YES )Q NO
had a business, professional or liquor APPLICATION OR LICENSE rejected denied revoked, suspended or
Red in this or any other state?
19. Has anyone EVER filed suit or obtained a judgment against you in a civil action, the subject of which ❑YES / NO
involved fraud or misrepresentation of a business professional or liquor license?
20. Are you NOW or have you EVER held ownership, been a controlling person , been an officer, member, director,
or manager on anv other uor license in this or any other state? [I YES NO
lgq
If any answer to Questions 15 through 20 is "YES" YOU MUST attach a signed statement giving complete details._
Please be sure to include dates agencies involved and dispositions.
If you checked the Manager box on the front of this form, fill in #21-23 and 24, all others skip the following box (21-23) and go to # 24
Manager Section
21. Have you attended a Department approved Liquor Law Training Course within the last 5 years? (Must provide proof) ❑ YES ❑ NO
If the answer to #21 is "NO" course must be completed BEFORE ISSUANCE of a new license OR APPROVAL on an existing license.
22. Do you make payments to the licensee? ❑ YES ❑ NO If "yes", how much? $ per month. Total debt to licensee $
23. Is there a formal written contract or agreement between you and the licensee relating to the operation or management of this business?
❑ YES ❑ NO If "yes", attach a copy of such agreement
24. I, Fr a h A P. it ► - e i e- i hereby declare that I am the APPLICANT filing this questionnaire.
(Print full name of Appkarn-O�
I have read this questionnaire and the contents and all statements are true, correct and complete.
1J J, State of &e6, 11,S- County
The foregoing instrument was acknowledged before me this
TERRI L TEFFT
My Comm. Ev. April S. 200/
My commission expires on: J u4gA:1
D of
N YP�UBLIC�)���
_, - --- -
FILL IN THIS SECTION ONLY IF YOU ARE A LICENSEE OR AGENT APPROVING A MANAGER APPLICATION
Licensee or Agent Approval of Manager
25. I,(Print Licensee/Agent's Name):
Last Middle First
Hereby authorize the applicant to act as manager for the named liquor license.
State of County of
The foregoing instrument was acknowledged before me this
X day of
(Signanue of LICENSEE/AGENI) Dry of Month Month Yr
My commission expires on:
Day of Morah Month Year (Signanae of NOTARY PUBLIC)
ARIZONA DEPARTMENT OF LIQUOR LICENSES & CONTROL
800 W Washington Sth Floor
Phoenix AZ 85007-2934
(602) 542-5141
QUESTIONNAIRE L�(iP� �;
L SECURITY AND BIRTHRATE INFORMATION IS C
kND CANNOT BE DISSEMINATED TO
instrument is a sworn
or
LN jdLov Congress #150
Tucson AZ 85701-1352
(520) 628-6595
DNFIDENTIAL B
PUBLIC
it with black ink
An extensive investigation of your background will be conducted. False or incomplete answers could result
in criminal prosecution and the denial or subsequent revocation of a license or permit.
CO BE COMPLETED BY EACH OWNER, AGENT, PARTNER, STOCKHOLDER (10% OR MORE), MEMBER, OFFICER OR MANAGER ALSO EACH PERSON
)ONE BY BONA FIDE LAW FORM ENFORCEMENT T SUBMIT AN AGENCY OR A FINGERPRMINGE FINGERPRINT CSER SERVICE APPROVED BRD WHICH MAY BE Y TEEDEARTMENT OF LIQUOR T FINGERPRINTING AT THE DEPT. PART T BE )OES NOT PROVIDE THIS SERVICE.
There is a $24.00 nrocessing fee for each finuerprint card submitted j
A service fee of $25.00 will be charged for all dishonored checks (AILS. 44.6852)
Check ❑Owner ❑Partner ElStockholder ❑Member ❑Officer ❑ Agent ❑ Manager(Only)
appropriate ❑ Other (Complete Questions 1-20 & 24) Complete All Questions except # 14,14a & 25)
box —, Licensee or Agent must complete # 25 for a Manager Licensee or ALyent mnct r•mmnle+n R,)c
Name: L-' i LL !A)w 6 Date of Birth:�,��
Last / G Fast Middle (This W' 1 t Become a Part of Public Records)
Social Security Number: 'S� 0 Drivers License #: 71�' Stater
/(This ill No Become a Part of Public Records)
.Place of Birth: _Z_r-_ A) -A, (�I iX ' �f% \ l L SAX% Height: , �10 Weight: _/f� E es: �z
City ! State CountryY A5� ai : c6P
Marital Status ❑ Single [Married ❑ Divorced ❑ Widowed Residence (Home) Phone:
Je of Current or Most Recent Spouse: _/�% / GV J� �" `� ���i)/yf/I%l Date of Birth: j1—��
om'
last 5 years - Use additot d sheet if necessary) st First MAdle Maiden
l
You are a bona.fide resident of what state? !/ If Arizona, date of residency- GK
Telephone number to contact you during business hours for any questions regarding this document. ( 7/,�1— /1
If you have been a resident less than three (3) months, submit a copy of ver's license or voter registration card.
I Name of Licensed .Premises: premises Phone: ( `' J - .L �v
1. Licensed Premises Address:`
iquor License #
i}oe ) ty/ C ZiP (If this location is currently licensed)
Z. List our employment or r°� ` r}otuse> B� # ` 1 �� l� GVI CbV
ytype of business d >r theoas rive (51 ve tunemnl ve Hart of the time list thncP .lnrpc 7 :�« ,,, �« «,..«
FROM
Month/Year
TO
Month/Year
DESCRIBE POSITION
OR BUSINESS
1aL 1J1.
EMPLOYER'S NAME OR N-AW—, OF BUSINESS
(Give street address, city, state & zip)
CURRENT
ATTACH ADDITIONAL SHEET IF NECESSARY FOR ETHER SECTION
Sdicate your residence address for the last five (5) ears:
OM
TO
RESIDENCE
Month/Year
Mcnth/Year
Street Address
Cltv. State
Zip
i U
-...
CURRENT
rr
Q U C/ —
'9
_
6 4 � M 4 1A IiYA ;Omni
�,
g
natidimi
J
u.w..__ , c4_u_� aYaz.uu P,c 'a kuvs)
Attachment 4
L Parks LRecreation
Community Center Use
Yoga 8 Week Sessions/ Spring, Summer, Fall, Winter
Mondays, 9:00— 10:00am 1 classroom
Tai Chi 8 Week Sessions/Spring, Summer, Fall, Winter
Wednesdays, 9:00— 10:00am 1 classroom
Bridge Lessons 4 Week Sessions/November& February
Fridays, 9:00— 11:00am 1 classroom
Friday Bridge Year Round
Fridays, 9:30am— 12:30pm 1 classroom
Spanish Club Year Round
Mondays, 12:30—2:30pm 1 classroom
Walking Club Banquet one time per year in February
Saturday, 6:00— 10:00pm
Family History Society
September through May
2nu Monday each month, 8:30am—12:30pm 2 rooms
National Recreation and Parks Month
Art Display in Lobby for month of July
Volunteer Banquet Banquet one time per year in April
Friday, 6:00— 10:00pm
Kiddie Rhythmics 4 Week Sessions/Spring, Summer,Fall, Winter
Wednesdays & Fridays, 3:30—4:30pm 1 classroom
Lecture Series 4 Week, One Evening Per Week/October &November
TBA, 6:00—9:00pm Either 2 Classrooms or Banquet Room
Arts & Crafts TBA
L
To: Town of Fountain Hills
Mayor Sharon Morgan
Vice Mayor Sharon Hutcheson
Council Member Leesa Fraverd
Council Member John Kavanagh
Council Member John McNeill
Council Member Susan Ralphe
Council Member John Wyman
We, the members of the Spanish club, are a bit confused by contradicting
information as to whether we will be required to pay for the use of the new
Community Center facilities. It is our understanding that you are going to clarify
the issue.
We meet weekly through the year to enhance the member's language
skills and thus gain a better understanding of the Spanish Speaking World.
The Parks and Recreation department for the past five years have
sponsored us.
The club is open to all residents and we charge no fees or dues. Because
of this we would be unable to pay for the use of the facilities.
e urge you allow us to continue using the Community Center for free.
C ?v,
✓A
Interoffice Memo
To: HONORABLE MAYOR AND TOWN COUNCIL
From: CASSIE HANSEN, DIRECTOR OF ADMINISTRATI N
Date: 07/25/01
Re: AGENDA ITEMS #10 AND #11 — RESOLUTION 2001-39 BUDGET ADOPTION
AGENDA ITEMS #10 AND #11 - PUBLIC HEARING AND ADOPTION OF RESOLUTION 2001-
39, ADOPTING THE 2001-2002 BUDGET
These two items begin the final phase of the budget process for fiscal year 2001-2002 that culminates
with the adoption of the tax levy. State law requires that the adoption of the property tax levy occur by
the third Monday in August. This requirement will be satisfied at the Council's regularly scheduled meeting
on Thursday, August 16 when the Council adopts the tax levy required to retire the secondary tax for the
voter-approved street paving project, the $1.4 million land preservation bond, the library/museum bond
and the $6 million mountain preservation bond.
sr.. Although there i no specific date set by law for the adoption of the final budget, state law does require a
period'oat lea seven days between the adoption of the budget and the tax le Adoption of the final
i Y P � 9 levy. P �
budget dt the August 2 meeting satisfies this statutory timeline. The only other requirement is that the
tentativebud efbe published for two consecutive weeks prior to the final adoption. This requirement will
have been met prior to the August 2 meeting. A public hearing precedes the adoption of the budget,
which has bee „,ers ier) notic d ccording to state law. Staff recommends approval of Resolution
• 2001-39. �`rrrttiv
di
I
Page 1 of 1 August 2, 2001 Agenda Items Last printed 07/25/01 1:14 PM
RESOLUTION NO.2001-39
• A RESOLUTION OF THE MAYOR AND COMMON COUNCIL
OF THE TOWN OF FOUNTAIN HILLS, ADOPTING THE
TENTATIVE BUDGET AS THE 2001-2002 FISCAL YEAR
BUDGET FOR THE TOWN OF FOUNTAIN HILLS.
WHEREAS, in accordance with the provisions of Title 42, Chapter 17, Articles 1-5, Arizona
Revised Statutes (A.R.S.), the Town Council of the Town of Fountain Hills did, on July 5, 2001, make an
estimate of the different amounts required to meet the public expenditures and expenses for the ensuing
year, also an estimate of revenues from sources other than direct taxation, and the amount to be raised by
taxation upon real and personal property of the Town of$1,338,094; and
WHEREAS, in accordance with said chapter of said title, and following due public notice, the
Council met on August 2, 2001, at which meeting any taxpayer was privileged to appear and be heard in
favor of or against any of the proposed expenditures and expenses or tax levies; and
WHEREAS, it appears that publication has been duly made as required by law, of said estimates
together with a notice that the Town Council would meet on August 2, 2001, at the meeting place of the
Council for the purpose of hearing taxpayers and making tax levies as set forth in said estimates; and
WHEREAS, it appears that the sums to be raised by taxation, as specified therein, do not in the
aggregate exceed that amount as computed in A.R.S. §42-17051(A);
NOW, THEREFORE, BE IT RESOLVED, that the said estimates of revenues, expenditures
and expenses shown on the accompanying schedules as now increased, reduced or changed by and the
same are hereby adopted as the budget of the Town of Fountain Hills for the fiscal year 2001-2002.
PASSED AND ADOPTED this 2nd day of August, 2001, b the Mayor a d Town Council of
Fountain Hills.
jVivq&'—
S aron Morgan,Mayor
A 1"1EST:
Cassie B. Hansen,Director of Administration/Town Clerk
REVIE BY/APPROVED A FO •
William E. Farrell, Acting To anager/Town Attorney
4 C BASS/F IL ^ I
N
SECOND rnc- 1364 II
COUNT t—O
Fiscal Year 2001 - 2002
General Fund Summary
i Exendtures
p
$17,228,342
Supplies and Services Capital Outlay
$1,898,690 $1,644,875
11% 10%
Contractual Services411, Transfers Out
$3,683,350 $2,673,150 16%
21%
Other Cont
26% $50,000ingency<1
Repairs&
Undesignated
�F %
Maintenance $1,500,764 9
$1,053,065
6% Police Dept.Capital
Reserve
Salaries and Benefits $250,000 1%
$4,474,448
26%
Nikr
2001-2002 Budget Town of Fountain Hilts-Budget Summary Sheets Page 3-3
Fiscal Year 2001 - 2002
General Fund Summary
Expenditures
by
Department
Mayor and Town
Council Building Safety
$104,660 1% $609,050 4%
Reserves and Marshal Department
Transfers $2,676,390 16%
$4,473,914 25%
Magistrate Court
$330,650 2%
Public Works
$680,010 4%
Information Technology
$301,190 2% 104
Parks &Recreation
$1,875,710 11%
ti
Community
Administration Development
$3,275,500 19% $406,080 2%
Engineering
Library/Museum Community Center
$866,930 5/°
$70,000 <1%
(Town Ctr)
$1,022,558 6%
Kiwanis/Senior Center Community Center
$508,600 3% — (Saguaro)
$27,100 <1%
if lib-
2001-2002 Budget Town of Fountain Hills-Budget Summary Sheets Page 3-4
Fiscal Year 2001 - 2002
General Fund Summary
Revenues
$17,228,342
Local Sales Tax Revenue
$4,500,000 22%
Building Permit Fees
JI $1,600,000 12%
Charges for Services
$244,600 1
zdiAl
Subdivision Fees
$150,000 2%
Fines&Forfeitures
Other $318,700 2%
State Shared
Revenues hterest/Miscellaneous
$4,357,200 19% $362,000 2%
Franchise Fees
$130,000 1
License Fees
$104,100 1%
Carry Forward
$5,461,742 38%
Page 3-2
2001-2002 Budget Town of Fountain Hills-Budget Summary Sheets
Law Offices of
William E. Farrell, P.L.L.C.
Tel(480)837-5750 William E.Farrell Building A.
Fax(480)837-5805 16838 E.Palisades Blvd.
E-mail billfarrellAgwest.net Fountain Hills,AZ 85268
STAFF REPORT
TO: Mayor and Council
Town Clerk
FROM: William E. Farrell
Acting Town Managd
DATE: August 2, 2001
RE: Resolution 2001-34 Employee Benefits Package
Council has previously discussed and tentatively approved several changes to the adopted
® personnel policies and procedures for the Town employees for the next fiscal year. Section 3 and
4 of the attached resolution reflect the additional 3 personal days per calendar year to be deducted
from sick leave if the employee does not have enough hours in sick leave in lieu of vacation time.
Section 4 describes the addition of grandparents and grandchildren to the definitions of immediately
family members.
Section 2 details a sick leave accumulation and payout program that the Council asked for
additional information regarding. Basically, Section 2 provides that if an employee with ten (10)
or more years of continuous full time service has accumulated and not used at least 480 hours of sick
leave time then the employee could be eligible for receiving 240 hours or 1 month's pay at the time
of retirement or voluntary termination of employment. The policy goes on that for employees with
15 years or more of continuous full time service who have accumulated and saved 720 hours of sick
leave that employee may then be eligible for payment of 480 hours or two month's pay in case of
retirement or voluntary termination.
I have reviewed the underlying statistical information on sick leave options with other cities
and towns in the state of Arizona as well as having personally visited with the employee committee
that made this recommendation. I believe Section 2 sets up a perfect balance wherein employees
will not feel that they must with go use of sick leave in order to continue to earn a possible benefit
at time of retirement. On the other hand this encourages to some degree the judicious use of sick
time for not only the primary reason of making sure that you have adequate sick leave for major
sickness or illness that will cover an employee until long term disability starts; but also the added
incentive of possibly receiving additional compensation identical to that for which we give for
accumulated but unused vacation time.
STAFF REPORT
Re: Resolution 2001-34 Employee Benefits Package
August 2, 2001
Page 2
I have visited with Human Resources and I am of the opinion that this will not create in any
calendar year an unforeseeable or unmanageable economic burden. We worked very closely with
the employees who are nearing retirement age and/or those employees with sufficient longevity(ie
10 or 15 years) as to what their plans and desires are in this area.
Based upon all of the foregoing I would recommend that the Council adopt Resolution 2001-
34 and implement the changes to the personnel policies and procedures. As always,we will attempt
to answer any questions you may have regarding this matter.
(11.
Z:\WPDATAWHRRES\2001-34MEM.wpd
4
I
RESOLUTION 2001-34
A RESOLUTION OF THE MAYOR AND COMMON COUNCIL OF THE TOWN OF
FOUNTAIN HILLS, ARIZONA, AMENDING THE PERSONNEL POLICIES AND
PROCEDURES FOR THE TOWN OF FOUNTAIN HILLS BY AMENDING POLICY 6.5
SICK LEAVE AND 6.6 FUNERAL LEAVE.
NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND COMMON COUNCIL
OF THE TOWN OF FOUNTAIN HILLS, ARIZONA, AS FOLLOWS:
Section 1. That the Town has adopted personnel policies and procedures and that the Council
wishes to amend those policies and procedures as follows.
Section 2. That policy 6.5 regarding sick leave is amended by adding a provision for the pay
out of sick leave hours upon separation of service for any reason other than
involuntary termination. Employees with 10+ years of continuous, full-time service
must have a minimum of 480 banked sick time hours in order to qualify for this
benefit, and will be paid out a maximum of 240 hours. Employees with 15+ years of
continuous, full-time service must have a minimum of 720 banked sick time hours in
order to qualify for this benefit, and will be paid out a maximum of 480 hours.
Section 3. That policy 6.5 regarding sick leave is amended by adding three personal days per
calendar year, which if used, will be deducted from the employee's sick leave
balance. If an employee does not have enough hours in their sick leave balance, they
will not be eligible for a personal day. There will be no carryover from year to year
of personal days.
Section 4. That policy 6.6 regarding funeral leave is amended by adding grandparents and
grandchildren to the definition of immediate family members.
PASSED AND ADOPTED by the Mayor and Common Council of the Town of Fountain Hills,
Arizona this 2ndth day of August, 2001.
F E TOWN OUNlT,,AINHIHILLS: ATTEST:
/C,. ) ,
k �— 0/k/)4LA3
�l.Gu
Sharon Morgan, Mayor Cassie B. Hansen,Town Clerk
REVI W BY AND AP713V TO FORM:
1
ilham E. Farrell, Acting Town Manager/Town Attorney
4 PAS AIL -- D
MOTION m Or`\an.
SECOND uQ.va
COUNT (a-O
Law Offices of
William E. Farrell, P.L.L.C.
Tel(480)837-5750 William E.Farrell Building A.
Fax(480)837-5805 16838 E.Palisades Blvd.
E-mail billfarrell(dgwest.net Fountain Hills,AZ 85268
MEMORANDUM
TO: Mayor and Council
Town Clerk
FROM: William E. Farrell
Acting Town Manager tA)r#
DATE: August 2, 2001
RE: Employee Benefit Issues
Sick Leave Accumulation
(or
I am attaching to this memo four charts to assist you in evaluating the recommendation
regarding sick leave accumulation. The first chart was actually at the request of one of the council
members who wanted to know without identification the employees currently eligible to participate
in the proposed sick leave accumulation and payout program. The seven employees currently
eligible would have a combined payout of$32,488 with an average payout of$4,600.
The second chart shows the number of full time employees and their months of service. The
chart is interesting in that the next fiscal year as many as 10 additional employees could join the
current 7 employees with more than ten years of service. We then experience a marked drop for the
next three years.
The third chart shows typical hourly salaries beginning at$10.00 and ending at $45.00 per
hour and what the gross amounts would be for the 240 hour payout and the 480 hour payout.
The fourth and final chart shows the last 10 employees who left the service of the Town and
what accumulation of vacation time they had at the time of separation. I hope this information is
of some assistance in analyzing my request for a favorable vote on the recommended action.
L.
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Town of Fountain Hills
�,., Memorandum
DATE: July 29, 2001
TO: The Honorable Mayor and Common Council
FROM: Jeffrey Valder, Director of Community Development
THROUGH: William E. Farrell, Acting Town Manager
SUBJECT: Town Council consideration of initiating an amendment to Sections 6.02 and 6.03 of The
Zoning Ordinance for the Town of Fountain Hills to prohibit neon signs.
Councilmember Kavanagh would like the Town Council to consider whether the Town should prohibit
neon signs. The Town currently permits neon signs and neon lighting to be used to outline buildings and
windows. If the Town Council desires to prohibit new neon signs, the Council should initiate the
following amendment to Sections 6.02 and 6.03 of The Zoning Ordinance for the Town of Fountain Hills.
New text is shown as double-underlined.
CHAPTER 6
SIGN REGULATIONS
,� 6.01 Purpose. These Sign Regulations are intended to encourage attractive signage for businesses and
services,while promoting the general welfare of the community by creating more aesthetic appearing
street frontages through the use of controlled signage.
6.02 Definitions. For the purpose of this Chapter, the conditions given in Sections 1.12 for definitions
therein shall apply.
Neon Si_`,n. Any sign that uses neon, argon or any similar gas to illuminate transparent or
translucent tubing or other materials, or any use of neon, argon or any similar gas lighting on or
near the exterior of a building or window.
6.03 General Regulations.
C. Signs not specifically authorized herein are prohibited, including, but not limited to the
following.
1. Sandwich signs except as otherwise provided(See temporary signs).
2. Signs mounted, attached or painted on trailers, boats, or motor vehicles to serve as
additional advertising signs on the premises.
3. Awning signs except as otherwise provided for non-residential uses.
4. Roof signs, or signs that project above the highest point of the roofline, parapet, or
fascia of the building.
Town Council Memorandum
July 29,2001
Neon Signs Prohibition Initiation Memo
Page 2 of 2
5. Any sign emitting sound.
6. Any sign with intermittent or flashing illumination,animated or moving signs.
7. Any neon sign,except for the following:
a. Reverse pan-channel signs where neon tubing is used inside of three-sided
solid metal letters to illuminate a wall on which the letters are attached,and
in a manner that the illuminated neon tubing is not visible.
b. A neon sign that had been specifically permitted by the Town,as a part of a
Town-issued sign or building permit, and that is maintained in strict
conformance with Chapter 6 of The Zoning Ordinance for the Town of
Fountain Hills.
C
TOWN OF FOUNTAIN HILLS
MEMORANDUM
TO: The Honorable Mayor and Common Council
THROUGH: William E. Farrell, Acting Town Manager
FROM: Dana Burkhardt, Senor Planner
DATE: July 24, 2001
SUBJECT: Special Use request by Joe Polese, aka Polese Pest Control, for a pest
control service as a home occupation, located at 15833 Ruskin Lane; Case
Number SU2001-07.
This request is for a Special Use Permit to operate a pest control service as a
home occupation on Plat 505-A, Block 1 , Lot 26. On July 12, 2001, the Planning
and Zoning Commission unanimously recommended the Town Council approve
j this special use application with stipulations. Please refer to the attached Planning
`�► and Zoning Commission & Staff report for additional details regarding this request.
If you should have any questions, I can be reached at 816-5138.
TOWN OF FOUNTAIN HILLS
STAFF REPORT
AUGUST 2, 2001
CASE NO: SU2001-07
PROJECT
MANAGER: Dana Burkhardt, Senior Planner
LOCATION: Plat 505-B, Block 1, Lot 26, 15833 Ruskin Lane.
REQUEST: Consider a Special Use Permit, which would allow for a home occupation
pest control business, including the storage of "hazardous materials", as
defined in Section 1.12 of the Zoning Ordinance.
DESCRIPTION:
APPLICANT: Joseph M. Polese, Polese Pest Control
EXISTING ZONING: "R1-10"
EXISTING CONDITION: Existing single-family residence in an
established single-family neighborhood.
PARCEL SIZE: 11 ,151.36 square feet (0.256 acres).
SURROUNDING LAND USES AND ZONING:
NORTH: Developed single-family homes, zoned "R1-10"
SOUTH: Hesperus Wash, zoned "R1-10".
EAST: Developed single-family home, zoned "R1-10".
WEST: Developed single-family home, zoned "R1-10".
SUMMARY:
This request is for approval of a Special Use Permit which would allow for a home
occupation pest control business, called "Polese Pest Control", including the storage of
hazardous materials, as defined in Section 1 .12 of the Zoning Ordinance, to be located at
15833 Ruskin Lane. According to Section 1 .12 of the Town of Fountain Hills Zoning
Ordinance, "Hazardous Materials" are defined as the following:
Any substance characterized as flammable solids, corrosive liquids,
radioactive materials, oxidizing materials, highly toxic materials, poisonous
gases, reactive materials, unstable materials, hypergolic materials and
pyrophoric materials and any substance or mixture of substances which is
an irritant, a strong sensitizer or which generates pressure through
exposure to heat, decomposition or other means.
The applicant is proposing to store all chemicals relative to the pest control
business within his vehicle, which is to be parked within his garage when not in the
field. Staff has received two letters from neighboring property owners opposing
SU2001-07
P&Z Commission and
Staff Report
August 2, 2001
Page 2
this request. The Fire Department has reviewed this proposal, including the
Material Safety Data Sheets for the pest control products, and has no objections
as long as the applicant subscribes to good housekeeping and storage practices.
The applicant has provided Materials Safety Data Sheets with this application. If
you wish to review this information, please contact me at (480) 816-5138.
On July 12, 2001, the Planning and Zoning Commission unanimously
recommended the Town Council approve this special use application with the
following stipulations:
1. The applicant shall comply and remain in compliance with Section 5.14 of the
Town of Fountain Hills Zoning Ordinance, titled "Home Occupations."
2. All chemicals must be stored and secured on the applicant's business truck and
kept in his garage at all times while at the residence.
3. Owner shall meet all requirements of the Structural Pest Control
Commission.
4. Allow for "Safety Surveys" of premises by the Fountain Hills Fire
Department.
5. Will store and secure all pesticides on the applicants vehicle at all times.
6. The amount of pesticides will not exceed the amounts specified in the
application.
7. The pesticide storage areas of the vehicle shall be labeled "Caution
Pesticide Storage".
8. Have ready absorbent material that is compatible with product.
9. Mount 51b ABC extinguisher within the vehicle or in the garage.
10. Have washing facility separate from residential living area.
11. Use proper decontamination procedures of clothing prior to entering
residential living area.
IL
12. Secure garage at all times.
13. Maintain good house keeping in work area.
SU2001-07
P&Z Commission and
Staff Report
August 2, 2001
Page 3
14. Maintain Material Safety Data Sheet book on all pesticides stored in vehicle.
15. Use proper disposal procedures per manufacturers directions.
At the Planning and Zoning Commission hearing, David and Judith Flett, residing
at 15838 Rusking Lane, and Bill and Kathleen Lord, residing at 16207 Runyon
Place, spoke in opposition to this request. Staff has also received a letter
opposing this request from Donald L. Disbrow, located at 15822 Ruskin Lane. The
primary concern of these neighbors is the nature of the proposed storage of
pesticides for commercial use.
Kevin Collins, currently residing at 17359 Calaveras, spoke in favor of this request.
Kevin stated that he is currently in escrow and will be residing directly adjacent to
the Polese residence within a few weeks. He has no objection to the proposed
special use given that the applicant maintains conformance to the staff
recommended stipulations.
RECOMMENDATION:
Staff and the Planning and Zoning Commission recommend approval of SU2001-07,
Special Use Permit for "Polese Pest Control", a home occupation pest control
business, with the following stipulations:
1. The applicant shall comply and remain in compliance with Section 5.14 of the
Town of Fountain Hills Zoning Ordinance, titled "Home Occupations."
2. All chemicals must be stored and secured on the applicant's business truck and
kept in his garage at all times while at the residence.
3. Owner shall meet all requirements of the Structural Pest Control
Commission.
4. Allow for "Safety Surveys" of premises by the Fountain Hills Fire
Department.
5. Will store and secure all pesticides on the applicants vehicle at all times.
6. The amount of pesticides will not exceed the amounts specified in the
application.
7. The pesticide storage areas of the vehicle shall be labeled "Caution
Pesticide Storage".
SU2001-07
P &Z Commission and
Staff Report
August 2, 2001
Page 4
8. Have ready absorbent material that is compatible with product.
9. Mount 5Ib ABC extinguisher within the vehicle or in the garage.
10. Have washing facility separate from residential living area.
11. Use proper decontamination procedures of clothing prior to entering
residential living area.
12. Secure garage at all times.
13. Maintain good house keeping in work area.
14. Maintain Material Safety Data Sheet book on all pesticides stored in vehicle.
15. Use proper disposal procedures per manufacturers directions.
L
Exhibits:
A) Section 5.14 (Home Occupations) of Town of Fountain Hills Zoning
Ordinance.
B) Memo from Mike Winters, Assistant Chief/Fire Marshal, dated
6/26/01 , and Memo from Todd Brunin, Deputy Fire Marshal dated
9/15/00
C) Application for Special Use Permit
D) Letters of objection
i
it
law
Adopted November IS, 199?
*25
5.14 Home Occupations. Home occupations shall be permitted in any residential zone, subject
to the following requirements:
A. Home Occupations shall be clearly incidental and subordinate to the use of the
property and dwelling unit for dwelling purposes, shall be conducted entirely within
the dwelling or garage, and shall not change the residential character thereof.
Carports, accessory buildings, and yards may not be used for home occupations.
There shall be no outdoor storage of materials relating to the business.
B. Area. No more than twenty-five (25) percent of the gross floor area of the dwelling
shall be devoted to the home occupation.
C. Employees. There shall be no employees other than members of the immediate
family residing in the dwelling unit where the hnm' nccunation is being operated.
D. Delivery Vehicles. No business shall be conducted which requires delivery
vehicles or other services not customary to a residence.
E. Nuisances. There shall be no external evidence of the activity such as outdoor
storage, displays, noise, dust, odors, fumes, vibration, or other nuisances discernible
•• beyond the property lines.
AD
F. Signs. No signs signifying the business or any commercial product or service are
allowed. Signs on business vehicles, regardless of their storage, shall not display the
address of the home occupation.
G. Traffic. Customer/patron and shipping/receiving trip generation shall not exceed
five (5) trips a day.
H. Exception. An exception to these requirements shall be made for the operation of a
group home for the handicapped and adult care, day care centers, home day care
centers, and model homes.
I. Hazardous Materials. Any home occupation desiring to use hazardous matenals,
as defined in this ordinance, must first secure a special use permit. No home
occupation may use hazardous material without a special use permit. Special use
permits for the use of hazardous materials will only be issued after the Town and
Fire District are assured that proper handling, storage, and disposal safeguards can
and will be followed for the health, safety and welfare of the neighborhood and
community.
m
2
Chapter 5 - General Provisions Page 5-22 X
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1.,,1 'I', Fountain Hills/Rural Metro Fire Department
P =U MEMO
I,- \'''..;;;;;;''''''''''' MMO
m
4
0
To: Dana Burkhardt
Town of Fountain Hills Senior Planner
From: Mike Winters
Assistant Chief/Fire Marshal
Subject: Polese Pest Control
Date: June 26, 2001
I have reviewed the submittal package, including the protest letter, regarding Polese Pest Control. The
quantities that Mr. Polese listed in this package are well below the exempt amounts listed in the fire code.
Since the amounts listed are small, there are no codes that address these amounts. Its is my opinion that as
long as Mr. Polese stores and uses these chemicals in accordance with manufacturers guidelines, and recog-
nized safety practices and procedures, there is not an immediate fire code issue. -
46
Mr. Polese has furnished this department with all of the Material SafetyData Sheets for theproducts that he
will be using, and I do not find anything that could not be found in the average persons garage. Many
aerosols that are commonly used in household applications are regularly stored in garages and other un-
vented areas, and there has been no incidents of explosions reported to us to date.
As long as Mr. Polese subscribes to good housekeeping and storage practices, the Fire Department has no
objections to this Special Use Permit request.
CO
STATION#1 PHONE:(480)837-9820
FAX:(480)837.6167
STATION#2 PHONE:(480)837-0804 CO
I
FAx:(480)837-1446 X
W
.,.t�. Fountain Hills/Rural Metro Fire Department I Pro
MEMOltlL1S.
To:
From: Todd Brunin, Deputy Fire Marshal
cc. Scott LaGreca, Fire Marshal
Date: Sept. 15, 2000
Subject: Special Use Permit
Stipulations for use and storage of "General Use" Category III pesticides, bait traps, powders and a
maximum of three 12-16 oz Category II aerosol cans.
Owner shall: Meet all requirements of the Structural Pest Control Commission.
1. Allow for "Safety surveys" of premises by the Fountain Hills Fire Department.
ra. 2. Will store all pesticides in locked cabinets as stipulated in letter from owner.
3. The amount of pesticides will not exceed two cabinets as specified in owners letter.
4. Both Cabinets shall be labeled "Caution Pesticide storage"
5. Have ready absorbent material that is compatible with product.
6.'Mount 51b ABC extinguisher next to work area.
7. Have washing facility separate from residential living area.
8. Use proper Decontamination procedures of clothing prior to entering residential living
area.
9. Secure garage at all times.
10. Maintain good house keeping in work area.
11. Maintain MSDS book on all pesticides stored in facility.
12. Use proper disposal procedures per manufactures directions.
c,
Permittee „_ 1%L c /gyp Kr , n
CO
Date \- ke\-
NCO
STATION#1 Phone: (602)837-9820
FAX: (602)837-1446 X
STATION#2 PHONE: (602)837-0804 LU
Fax: (602)837-6167
/'t"I'&
$ TOWN OF FOUNTAIN HILLS
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•
-44:�-,,,,1 COMMUNITY DEVELOPMENT DEPARTMENT
- =SPECIAIRJSE-PERMI APPLJCAT1ON'z . R,_,; _ .-
Date Filed ,
{Fee Paid -7 0 c.0 t 9 S L. LC..t. Accepted B
/// / Q ' --17--ta ,t —1 cic, c':- -(:--e_,( 01.4
Type of Special Use Requested
1 -c_ S T C r,. iv TV C___
Address of Subject Property
1 Sa 3 3 ku s k/nl A,' - o 1 Zoning
Legal Description: Plat Block
3 c 5 - B Lot(s)
Applicant f-}(1Lk S () .z 7 C c Iv T 1._L� L
\, Sr `t 1 . Day Phone
Cc__ LCSC'-- yS_—S/6_-, -- ( 4/SI
Address
15 3 ku s k/ni C nl Icity ,-N STr) Zip Owner Z, 5 <c,
S C �� f f( T • AQ� Day Phone
Address
_ ilk,- S/L. - DVS /
lS 33 R., Slyfly, Ln,, ICitY /-/4 STilZ Zip
8s2 s'Signature of Owner I HERBY AUTHORIZE(Please Print)
Date
ivGt TO FILE THIS APPLICATION. / /
Subscribed and sworn before me this day of
, 19
My Commission Expires
Notary Public
Please Provide the Following (attach additional sheets): (Seal)
1. Mailing labels with names and addresses of all property owners within 300 feet of the external
boundaries of the subject property.
2. 3 full size prints (preferably 24"X36") of the site plan showing minimum zoning requirements and the
proposed development if the Special Use Permit is granted, as well as the exterior elevations.
3. 1 8.5" X 11" photostatic reduction of each of the above referenced exhibits.
4. Describe the proposed use, the operations of the use, and the facilities proposed for the land use.
5. A narrative describing any adverse impact the proposed land use may have on the surrounding V
properties and on the neighborhood and what steps will be taken to avoid these adverse impacts. F-
TFH Case Number CO Schedule Attached
w
r./
April 26,2001
To: Town of Fountain Hills
From: Joseph M. Polese
Subject: Special Use Permit
I am requesting approval of a special use permit for the
storage of restricted use pesticides on my F-150 Ford truck. The
truck will be parked in my garage when not in use in the field. My
truck will be locked at all times while transporting the pesticides.
I have lived in Fountain Hills since 1995 and have been
working for a Fountain Hills pest control company since 1995. I
am now starting my own company named Polese Pest Control.
Sincerely,
Joseph M. Polese
C)
C
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X
W
June 18, 2001
``.
To: Town of Fountain Hills
From: Joseph M. Polese
Subject: Chemical Storage
The following chemicals shall be stored on my truck in my garage every night for
the purpose of my business Polese Pest Control:
BRAND NAME ACTIVE INGREDIENT SIZE QUANTITY
Suspend SC Deltamethrin 1 pint 6
Kicker Pyrethrins/piperonyl butoxide 1 pint 1
Talstar PL Granular Bifenthrin 25 lbs 1
DeltaDust Deltamethrin 5 lbs 1
Max Force Insect Bait Hydramethylnon 6 lbs 1
Max Force Ant Stations Fipronil 1.2 oz 24
Max Force Roach Stations Hydramethylnon 3.81 oz 72
Max Force Roach Gel Fipronil 2.1 oz 3
Maki Bait Packs see MSDS 1.5 oz 100
York Pro-Fogger Pyrethrins/piperonyl butoxide 5.0 oz 6
Dicarboximide/benzeneacetate
Prozap Insect Gurad Jr Dichlorvos,2.2-Dichlorovinyl .37 oz 6
Dimethyl phosphate
CB Stinger Tetramethrin/phenoxybenzyl 14 oz 1
Cyclopropanecarboxylate
CB-123 Extra Pyrethrins/piperonylbutoxide 20 oz 1
N-octyl bicyloheptene dicarboximide
Sincerely,
\ 0-14 Yti
Joseph M. Polese
CO
X
W
July 10,2001
Town of Fountain Hills
Planning and Zoning Commission
PO Box 17958
Fountain Hills,AZ 85269
Re: SU2001-07 (Polese Pest Control, 15833 Ruskin Lane)
Sir/Madam:
Residential zoning is for homes, and not for the storage of restricted, highly concentrated,
toxic,pesticides used in a business. It is time to stop the"rubber-stamp process"of approving permits
without considering the possibility for abuse in the future,and start monitoring existing home occupations.
On May 30,2001,I discovered a"public notice"sign in my neighbor's yard,and contacted the Planning
and Zoning office for information. After researching the ramifications of pesticide storage, I then wrote the
Town of Fountain Hills on June 10,2001. An alleged"address mistake"also had prevented notice delivery
to many neighbors,causing the hearing date to be moved. Still,it took just a few days for Mr.Polese to
furnish a revamped chemical list(now accompanied by MSD sheets—some outdated and incorrect),but it
took weeks for the"new"public notice sign to appear in his yard. Only after the sign reappeared did my
very tardy"official notice"arrive,a notice making only a bland request for a"Home Occupation." It's no
wonder that there were virtually no complaints!
In fact,no"public notice"posted,published,or received by me made any reference whatsoever to the
storage of chemicals. Although released to me only upon request,Polese's own statement,(which
accompanied his application dated April 26,2001),was very specific:He asked for a permit "for the
storage of restricted use pesticides." Also,the Town Staff Report(dated June 14,2001)states in its
summary that the proposed permit would include "the storage of hazardous materials." Pertinent
information was left out of the public notice. Why? Are we being deliberately misled?
Any single violation of Arizona State licensing rules can cause Polese to lose his license to run a pest
control business. However,if Polese were to follow the June 14,2001,Town Staff Report's stipulations
requiring storage of"all chemicals"(Quantity limits? Concentration limits? No)on a hot truck,he would
be violating the terms of his license. In his memo of June 26,Fire Marshal Winters seemed nonchalant
about pesticide storage,assuming that Polese's pesticides are found in"the average person's garage." I,
however,learned from reading labels, Material Safety Data Sheets,and checking concentrations that
restricted chemicals are to be sold to,stored by,and applied by professionals only. Furthermore,that little
ol'six-pack of little ol'6-ounce cans ofAventis "Suspend SC"actually can make more than two 55-
gallon drums of pesticide. It contains unknown,possibly harmful, "inert"ingredients. It must be
stored at room temperature. It must be mixed as needed,because it cannot be stored in a diluted state,
and must be disposed of(where?)if not used within a short time. Just this one chemical—in the"small"
amount that Polese claims he will store(although no town official has yet to impose limits on quantities or
concentration)-will spray about 130 homes! 130! What"average person"keeps that in his garage?
For the future safety of all of us living nearby,and for the ultimate safety of Polese's children,his wife,
and himself,the only place for him to store ALL of his chemicals is elsewhere,in a properly zoned area,in
a temperature-appropriate facility. Then,the town should start monitoring all such businesses. Today's
sloppy pesticide business could well become tomorrow's Superfund site.
Sincerely,
,)/__
1406
Judith H. Flett
(6.- 15838 Ruskin Lane 0
Fountain Hills,AZ 85268 I-
m
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June 10,2001
Town of Fountain Hills
Planning and Zoning
PO Box 17958
Fountain Hills,AZ 85269
Re: Polese Pest Control request for Special Use Permit(SU2001-07)
Sir/Madam:
My across-the-street neighbor,Joe Polese,has applied for a Special Use Permit,so he may be able to store
miscellaneous pesticides on his property("on a pickup truck")to use in his new pest control business. I do
not want to deny him his right to operate his business,but I have had some misgivings about both his
request and the staff recommendation(copies of which I was able to obtain on June 7).
First,my husband and I were never notified of his intentions(request was filed April 26),because it
appears that a"mistake"may have been made regarding our mailing address. According to the mailing list
(a copy of which I also obtained on June 7), our label showed a"Pageland Circle"mailing address. We
and the Poleses very often appear at our mailboxes at the same time to retrieve our mail, so it's
unbelievable that he would not know our mailing address is the same place as our home!
Second,I find it unusual that a person could run a successful business using only the listed pesticides,
storing them only in/on a hot pickup truck. What happens with resupply? Will all be in/on the truck?
Third,Mr.Polese should have listed the CHEMICAL names of the pesticides he proposed to store,not the
brand names. He also should have, in his narrative,been required show the toxicity of each chemical: _=
Suspend SC is Deltamethryn;Talstar is Bifenthrin; Pro Control Plus is Cyfluthrin. All are Pyrethroids.
Strikeforce HPX is Chlorpyrifos,which was banned in 2000 because of its toxicity, but sales were allowed
to continue until supplies were exhausted(thus,it's not illegal—yet). After spending hours online
researching the listed"chemical names"(actually brand names),I found that many are class II chemicals
(Class I being the most toxic),and most,if not all,are not supposed to be stored in a hot place.
I want Joe Polese to be able to run his business, but in a responsible way. While I'd prefer for him to get
rich being the most environmentally friendly"bug guy", I don't have that choice at this point. So-
My suggestions to both Planning and Zoning and also to the Town Council are:
1. Require proper—not easy—storage of all chemicals. Just because they are stored in a truck
doesn't protect those of us nearby from danger.
2. Demand specific limits on the amount and types of chemicals stored,rather than simply
stating"all"on the staff recommendation.
3. Provide for some sort of future verification of adherence to the rules allowing the permit. It's
not fair to those of us who may be exposed to chemicals we apparently have no control over
to be saddled with monitoring a neighbor's business.
4. When noxious chemicals are involved,the Fire Board,which gives its stamp of approval so
easily, should be required to put its approval in writing,proving that it indeed knows exactly
all aspects of the chemicals it approves.
nvironmentally yours,
Judith Flett(15838 Ruskin Lane)
I-
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--� beyfc( es-Ii ( c(c s, ,
11PIIESS I«11.EANE
Beyond pesticides/National Coalition Against the Misuse of Pesticides
701 E Street, SE, Washington DC 20003
202-543-5450 (voice), 202-543-4791 (fax)
info@beyondpesticides.org
FOR IMM IATE RELEASE Contact:Jay Feldman or Kagan Owens
UNE 8, 2000 202-543-5450
Environmentalists Urge Homeowners, Applicators and Farmers to Stop Use and
Retailers To Stop Sale of Common Pesticide Subject to Partial Ban
EPA's announcement today will stop the sale by December 31,2001 of most residential uses of the
third most commonly used home-use and commercially applied pesticide, chlorpyrifos(DursbanTM,
LorsbanTm), but allows these uses to continue until stocks are depleted. Containerized baits with
chlorpyrifos will remain on the market.Most current uses of the chemical will be allowed to
continue in agriculture and various noncrop,nonresidential uses, including golf courses and
greenhouses and for mosquito control and fire ants. Spot and local treatment for termites(post-
construction) will continue until December 31, 2002. New home treatment(pre-treat)will continue
until December 31, 2005 while exposure to people in this situation is studied.Export of the product
will continue Without restriction.Environmentalists are urging that homeowners, applicators and
- farmers stop their use and retailers stop sale of chlorpyrifos immediately in light of its known
neurotoxic properties.
g D.C.,June2000) Agency (EPA)announced a
(Washington, 8, While the Environmental Protection A en
-o it broad agreement with chemical manufacturers to phase-out the home and garden uses for the
widely used insecticide chlorpyrifos (DursbanTM, LorsbanT"),environmentalists urged the public to
stop using the chemical immediately.Today's agreement phases-out production of most home and
garden uses of chlorpyrifos by the end of the year, permits sales through 2001,and allows existing
stocks to be depleted.Uses that will be allowed to continue include all food uses(except tomatoes),
golf courses,greenhouses, and mosquito and fire ant control.Spot and local treatment for termites
(post-construction) will continue until December 21, 2002. New home treatment(pre-treat) will
continue until December 31,2005,while exposure to people in this situation is studied. Export of
the product will continue without restriction. Q
I-
"When it comes to pesticides,including chlorpyrifos,consumers are in a buyer-beware CO
marketplace, where they need to avoid exposure to pesticides that EPA has identified as hazardous
but left in commerce," said Jay Feldman, executive director of Beyond Pesticides/National W
Coalition Against the Misuse of Pesticides(NCAMP).
R c1 o s o L : DOEPOSE -ra -1-E rwP PES o U'EEe 1 .°b
C i A cos C-b v EH-i s L_E ? ) z-r- C A nJ EKPL-ob t- ,
•
',aror
New York State Attorney General Eliot Spitzer said today,"Protecting the public from toxic
materials is one of the most important functions of government."'That is why I am asking New
York retailers to remove all chlorpyrifos products from their shelves immediately and take the lead
in providing non-toxic pest control alternatives to their customers."According to Mr.Spitzer,"EPA
has taken an important step in the right direction,but if we are really serious about protecting the
public,especially the health of our children,we must do more to prevent exposure to this
dangerous chemical."
With over 11 million pounds of the chemical active ingredient chlorpyrifos applied annually in the
home and garden,this insecticide ranks third among all pesticides applied by homeowners and
commercial applicators. It is used extensively in commercial buildings,schools,daycare centers,
hotels,restaurants,hospitals,stores,warehouses,food manufacturing plants,vehicles(i.e.buses,
planes,trains),and agriculture. In agriculture,13 million pounds are applied annually,which
ranks chlorpyrifos thirteenth among all agricultural pesticides.EPA released a risk assessment of
chlorpyrifos in October, 1999.
Choorpyrifos is in the family of approximately 40 widely used organophosphate pesticides,known
neuro-toxic chemicals that together can cause cumulative adverse effects.Because of its high
volume and common uses,chlorpyrifos represents one of the most significant sources of
organophosphate exposure in non-occupational settings.Between the years 1993-1996,the most
recent reporting years,17,771 cases of unintentional residential chlorpyrifos exposures were
reported to poison control centers.EPA's pesticide program,which disbanded its Pesticide Incident
Monitoring System in 1981,does not collect adverse effects reports of pesticide poisoning,except
those reported by the chemical industry.
"Nothing short of a ban of all uses of chlorpyrifos will protect the public from the chemical's
adverse effects to the nervous system,"said Mr. Feldman. "Since less toxic and non-toxic
alternatives are available for all chlorpyrifos uses,it is wrong and unnecessary to allow chlorpyrifos
uses to continue,"said Mr.Feldman.EPA has a history of striking compromises on chemicals like
chlorpyrifos.In 1999,despite headlines indicating the banning of two organophosphate pesticides,
methyl parathion and azinphos-methyl,EPA's decision left on the market many uses that account
for a significant portion of the chemicals'overall poundage.
Beyond Pesticides remains extremely concerned about the continued commercial and agricultural
uses,exposure through residues in and on food,farmworker exposure,and direct public exposure
from mosquito control, containerized baits used indoors,and termite applications made by
pesticide applicators.A decision limited to over-the-counter uses is inadequate to the protection of
the public's health,according to Beyond Pesticides."EPA should be in the business of preventing
harm rather than calculating acceptable risk levels that allow people to be hurt,despite the
availability of safer alternatives,"said Mr. Feldman.
Dow AgroSciences and predecessor chlorpyrifos producers have received thousands of poisoning
reports.Victims of chlorpyrifos poisoning want EPA to stop the pesticide poisoning of all people.
11Ir.
## CO
W
low
Donald L Disbrow
15822 E Ruskin Lane
Fountain Hills, AZ 85268-1811
480 837-4923
June 25, 2001
Planning & Zoning Commission
Town of Fountain Hills
16834 E. Palisades Blvd.
Fountain Hills, AZ. 85268
Re: Special Use Permit for Poleses Pest Control
Dear Commission:
I reside about 80 feet from the applicants property on Ruskin Lane, a cul-de-sac
street with only one access, and in-a,residential area.
The type of commercial business proposed belongs in a commercial zone. It is not
like a home occupation such as the ones allowed in a residential zone.
I am opposed to this Special Permit for Polese Pest Control & Extermination Service
to operate in this residential neighborhood because of the increase in traffic,
and decrease in my property values.
Thank you for your attention.
Ver truly
�yours,✓�
cLl ri4/Dt7 G.2-�p
J t✓
Donald L. Disbrow
CI
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TOWN OF FOUNTAIN HILLS
MEMORANDUM
`o.
TO: The Honorable Mayor and Town Council
THROUGH: Paul Nordin,Town Manager
FROM: Jesse Drake, Senior Long Range Planner Jp
DATE: July 27, 2001
SUBJECT: Consideration of the Special Use Permit for" US Currency Protection
Corporation".
This request is for approval of a Special Use Permit which would allow the storage and use of
hazardous materials as a part of the business services for US Currency Protection Corporation, a
manufacturing facility owned by Mr. Glenn Karlberg, located at 16611 East Laser Drive, Suite 101.
Please refer to the attached Staff report for additional details regarding this request.
TOWN OF FOUNTAIN HILLS
�.. PLANNING AND ZONING COMMISSION AND STAFF REPORT
August 2, 2001
CASE NO: SU2001-08
LOCATION: 16611 East Laser Drive, #101, aka Final Plat 414, Lot 52.
REQUEST: Consideration of a Special Use Permit, which would allow the storage and
use of hazardous materials as a part of the business services used at a
proposed manufacturing facility.
PROJECT MANAGER: Jesse Drake, Senior Long Range Planner
DESCRIPTION:
APPLICANT: US Currency Protection Corporation
OWNER: Glenn Karlberg
EXISTING ZONING: "I-2" P.D.
EXISTING CONDITION: Vacant land
SURROUNDING LAND USES AND ZONING:
NORTH: Existing industrial building, zoned"IND-1"
SOUTH: Existing Salt River Project facility, zoned"IND-1"
EAST: Existing industrial building, zoned"IND-2 P.D."
WEST: Existing industrial building, zoned"IND-2 P.D."
SUMMARY:
This request is for approval of a Special Use Permit, which would allow the use and
storage of hazardous materials as a part of the normal business operations of US Currency
Protection Corporation. The facility will be located in a new 7,182 square foot industrial
building which will be used for both administrative offices and the manufacturing facility.
The company uses hazardous materials in the production of tear-gas dye packs. The dye-
pack is a disguised stack of currency containing an internal circuit board and chemical
pouch that are activated during a bank robbery, staining both the cash and the assailant.
The small chemical pouch in the dye-pack contains a combination of red dye, red smoke
and a tear gas irritant. The product is used primarily by the banking industry to prevent
loss of funds.
It is anticipated that the chemical handling and storage area will comprise approximately
200 square feet (3%) of the building area. The hazardous chemicals in the dye-pack pouch
will be mixed and loaded into pre-manufactured pouches in the 90 square foot assembly
room which will be isolated from the main manufacturing floor. All hazardous materials
41116.- will be stored in the remaining 110 square feet adjacent to the mixing room.
The chemicals will be delivered to a loading area via UPS trucks in twenty-pound
packages. Each package contains an approximately gallon sized metal drum protected by a
corrugated cardboard cover.
EVALUATION:
The manufacturing, processing, and storage of hazardous materials are permitted in
Industrial zoning districts with an approved Special Use Permit. The business has been
located in this area since 1986, under the current ownership since 1995. There is no record
of accidents or mishandling of hazardous materials at the current location of 16508 E.
Laser Drive, Suite 101. This Special Use Permit is required because the prior Special Use
Permit is valid only at the current location and cannot be transferred to the new building
location.
At present the business has twelve employees. The hours of operation will be from 8 AM
to 4:30 PM Monday through Friday. Parking for all employees will be accommodated on
the site. There are no off-site requests involved in this Special Use Permit application.
tor There are no requirements or regulations in the Firerock Centre Plan of Development
that would restrict the use at this location. All of the hazardous materials will be
contained within a small, confined area inside the manufacturing facility. No noise,
fumes or gases will be emitted from the facility because the processing of the chemicals
will be contained within the closed room that will contain a filtered ventilating system.
The employee handling the chemicals wears a reusable breathing hood, protective
overall suit, and wears disposable latex gloves. The gloves protect the employee from
the red dye stain. The gloves and empty containers will be placed into the outside trash
container. Waste Management Services is aware of the disposal of the materials into
the trash container and is satisfied that no special disposal requirements will be required.
Both the Town Marshal and Fire Department are aware of the nature of the materials to
be used at the site and regularly review the existing facility for any violations in handling
of the materials. No accidents or violations have been recorded.
Although the details for the proposed new facility have not been finalized, a proposed site
plan, together will a report from the Fountain Hills Fire Department with ratings and
ratings sheets for all chemicals used at the facility have been included with this report.
RECOMMENDATION:
The Planning and Zoning Commission recommended approval of SU 2001-08, "US
Currency Protection Corporation" on July 12, 2001, and staff recommends approval of
SU 2001-08, "US Currency Protection Corporation'.
R
, 004 4. ,
iC'E <cc TOWN OF FOUNTAIN HILLS
6 .it 1
COMMUNITY DEVELOPMENT DEPARTMENT
iJ
Pi;4742- -� t f " S ECIALEUSE--:PERM[T APeUCATIONz' ((i
Date Filed 1 Fee Paid Accepted By
! I � I b $750 . 00 ii. b-
Type of Special Use Requested
Storage of Hazardous Materials
Address of Subject Property Zoning
16611 E. Laser Dr. , #101 , Fountain Hills AZ 85268 I-2
Legal Description: Plat Block Lot(s)
414
Applicant Day Phone
USd Currency Protection Corp.
g 480-837-3773
1db as£ E. Laser Dr. , Suite 101 ' ' City Fountain Hi11§T AZ Zip 85268
Owner Day Phone
Glenn Karlberg
480-837-3773
q
gn5g E. Laser Dr. , Suite 101 Cit 'ountain HillsST AZ Zip85268
Cnature of I HERBY AUTHORIZE (Please Print) Date
' � April 25, 20C1
,"- TO FILE THIS APPLICATION.
".a k
Subscribed and sworn before me this ``-C day of . 0 : ,1,
7. 4`� -4'. J . , ' - - -'OF'"i` EAL Z. =9
•r: My Commiss�( .. ,gin.'.,- .::�:i .i , . , 1,
Notary Public r ,.+ Il •NOTARYPUBLIC-ARIZONA
r \�.' ' MARICOPA COUNTY f
r • 9 • My Comm.Expires Sept 7,2004 4
(Seal)
Please Provide the Following (attach additional sheets):
1. Mailing labels with names and addresses of all property owners within 300 feet of the external
boundaries of the subject property. Attached
2. 3 full size prints (preferably 24"X36") of the site plan showing minimum zoning requirements and the
proposed development if the Special Use Permit is granted, as well as the exterior elevations. Attached
3. 1 8.5" X 11" photostatic reduction of each of the above referenced exhibits. Attached
4. Describe the proposed use, the operations of the use, and the facilities proposed for the land use.
See attached Supplemental Letter
A narrative describing any adverse impact the proposed land use may have on the surrounding
_ perties and on the neighborhood and what steps will be taken to avoid these adverse impacts. None.
TFH Case Number
Fee Schedule Attached 00 1_/'
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UNITED STATES CURRENCY PROTECTION
CORPORATION
•
Re: Supplemental Letter to Special Use Permit Application
•
In regard to the Application for a Special Use Permit, we are pleased to provide the following
information regarding our business:
• General Description of Business
US Currency Protection Corp. ("USCPC"), is one of the world's leading producers
and sellers of tear-gas dye packs, principally used by banks to prevent loss of funds
and to recover stolen funds from bank robberies. A dye pack is a disguised stack of
currency notes, with an electronic circuit board and chemical pouch inside (the stack •
of bills) that expends when a bank robber leaves the bank, staining the cash and the
assailant. Dye packs are sold through the US and in approximately 30 countries
around the world. The small chemical pouch in the dye pack contains a mixture of
red smoke& dye and CN tear gas(which acts as an irritant, not a debilitant).
Founded in 1961, USCPC moved to its present location in Suite 101 at 16508 E.
Laser Dr. in approximately 1986. Here we have our administrative offices and
manufacturing facility. Our manufacturing consists of final assembly of the
electronic circuit board,and the chemical pouch into the Stack of bills. The chemical
pouch is loaded in a small room (approximately 80 sq. ft.) off of our manufacturing
area. All of our chemicals are stored in this room. The chemicals are mixed and
loaded into pre-made pouches. Every bit of chemical is used and there is no waste
from this minor part of our operation. Once the product goes through final assembly
and test it is shipped out to our service personnel located around the country (or to a
foreign distributor),who perform the installation and service work with respect to our
product.
Please note that the Fountain Hills Fire Department has inspected and reviewed our
use, handling and storage of the minor amounts of chemicals (hazardous materials)
that we maintain here since at least 1990. In our business we have the pleasure of •
• working closely with police departments around the country as well as the FBI and
the Treasury Department.
16508 East Laser Drive • Fountain Hills,Arizona 85268 • 480.837.3773 • Fax 480.837.3774 • protection@uscpc.com
• Details concerning Hazardous Materials
Hazardous materials used:
Chemical Max Qty. Stored Min.Qty. Stored
Atacryl Red 4G(Dye) 22 lbs. 2 lbs
(Purchased in 20 lb. Containers)
Smoke Mix(Classed as Potassium
Chlorate) 22 lbs. 2 lbs.
(Purchased in 20 lb. Containers)
CN 121 Tear Gas(powder)
(Classed as Chloroacetophenone) 22 lbs. 2 lbs.
(Purchased in 20 lb. Containers)
Isopropyl Alcohol(Classed as IPA) 12 gals. 2 gals.
The Fountain Hills Fire Department maintains MSDS sheets on each of these items, from
their annual inspections. The quantities we use in each dye pack are very small, thus we
order in the smallest containers the chemicals come in and our re-order points are fairly
low. As noted above, we mix the dye with the smoke mix and tear gas and fill up plastic
pouches which go inside the stack of bills. There is little to no waste involved in this
operation, as the chemicals are very expensive.
i..
Report from Fountain Hills Fire Department
See Accompanying Sheets for rating information
Chemical Health Flammability Reactivity Special Hazards
Name Rating Rating Rating Rating
Atacryl Red 4G(Dye) ratings unknown
Potassium Cholorate 2 0 3 oxy
Chloroacetophenone 4 0 1 corrosive W
Isopropyl alchohol 2 3 0 ----
Propylene glycol 2 1 0 ----
704'6 IDENTIFICATION OF
THE HAZARDS OF MATERIALS FOR EMERGENCY RESPONSE
but less than or equal to 200 milligrams per 1,n(mg/kg); ogram 0 Materials that, under gency cr,of •
would ofert no hazard embeyonder tha t ,nadd,imannn.
Materials that are corrosive to the respiratorytract combustible materials.The following criteria shall
Materials that are corrosive to the eye or cause irre_ be considered when rating materials:
cose
versibl corneal opacity;
Ma that are severely irritarin Gases and vapors whose LC51 for acute inhala-
g and or corro- Lion toxicity is greater than 10.000 parts pet mil-
sive to skin;
Materials whose LD50 for acute oral lion (ppm):
towctry. Dusts and mists whose LC;,, for acute inhala-
is greater than 5 milligrams per kilogram (mg/kg),
but less than or equal to 50 milligrams per kilogram non toxicity is greater than 200 milligrams per
( liter(mg/L);
mg/kg).
Materials whose LD50 for acute dermal tonicity
2 Materials that, under emergency conditions, can is greater than 2000 milligrams per kilogram
cause temporary incapacitation or residual injury'. Materials The following criteria shall be considered when greater than milligrams20h0o0� LDsn for acute oral toxicity is
rating materials: per gram (mg/kg):
Gases whose LC for acute inhalationtract,eyesaalnd skiy nrritattng to the respiratory
LC50 toxicity is
greater than 3000 parts per million (ppm),but less
than or equal to 5000 parts per million(ppm);
Any liquid whose saturated vapor concentration
at 68°F(20°C) is equal to or greater than one-fifth Chapter Flammability Hazards
(t/s)its LC50 for acute inhalation toxicity,if its LC50 3-1 General.
is less than or equal to 5000 parts per million(ppm)
and that does not meet the criteria for either degree 3-1.1 This chapter shall address the degree of susceptibil-
of hazard 3 or degree of hazard 4; ity of materials to burning. Since many materials will burn
Dusts and mists whose LC50 for acute inhala- under one set of conditions but will not burn under others,
tion toxicity is greater than 2 milligrams per liter the form or condition of the material shall be considered,
(mg/L),but less than or equal to 10 milligrams per along with its inherent properties.The definitions for liquid
liter(mg/L); classification are found in NFPA 30.Flammable and C
Materials whose LD50 for acute dermal toxicity bit Liquids Code. vmbtesti-
is greater than 200 milligrams per kilogram
(mg/kg),but less than or equal to 1000 milligrams 3-2 Degrees of Hazard.
per kilogram (mg/kg);
i
3-2.1* The degrees of hazard shall be ranked according to
Materials that are respiratory irritants;
Materials that cause irritating but reversible the susceptibility of materials to burning as follows:
ilkiitinjury to the eves;
Materials that are primary skin irritants or 4 Materials that will rapidly or con.r.letely vaporize
sensitizers; at atmospheric pressure and normal ambient
temperature or that are readily dispersed in air,
Materials whose LD50 for acute oral toxicity
is greater than 50 milligrams per kilogram, and which will burn readily.This includes:
but less than or equal to 500 milligrams per kilo- Flammable gases;
gram (mg/kg). flammable cryogenic materialc•
Any liquid or gaseous material that is liquid
while under pressure below
1 Materials that, under emergency conditions, can 73°F (22.8°C) and a bolingspoint belowa flash p 00°F
cause significant irritation. The following criteria I (37.8°C)(i.e.,Class IA liquids);
shall be considered when rating materials: Materials that ignite spontaneously when
Gases and vapors whose LC50 for acute inhala- exposed to air.
non toxicity is greater than 5000 parts per million
(ppm), but less than or equal to 10.000 parts
million (ppm); per 3 Li qui ds and solids that can be ignited under
mists whose LC50 for acute inhala- almost all ambient temperature conditions. Mate-
Duststion andisrials in this degree produce hazardous atmo-
ti n toxicity, but is greaterthan than 10or lnml2 0 milligrams
liter spheres with air under almost all imbient temper-
per liter(mg/L); attires or, though unaffected by ambient
temperatures,are readily ignited under almost all
Materials whose LD50 for acute dermal toxicity
is greater than 1000 milligrams per kilo aIT1 conditions.This includes:
(mg/kg),but less than or equal to 2000 milligrams (22.8 Liquids having a flash point below 73°F
per kilogram (mg/kg); (22.8°C) and having a boiling point at or above
Materials that are slightly irritating to the respi- 100°F (37.8°C) and those liquids having a flash
natant tract,eyes, p point at or above 73°F (22.8°C) and below 100°F
Materials whose and skin;50 for oral toxicity is (37.8°C)(i.e.,Class IB and Class IC liquids);
greaterMatthan 500o milligramsacute a m (mg/kg), Materials that on account of their physical form
but less than or equal to 2000 per kilogram
), or environmental conditions can form explosive
gram(mg/kg). er mixtures with air and that are .cadily dispersed
in air;
1996 Edition
INSTABILITY HAZARDS 704-7
_---
Materials that burn with extreme rapidity,usu- or polymerization, or can undergo violent explosive re.u-tion
ally by reason of self-contained oxygen (e.g., dry through contact with water or other extngushint agents o.
nitrocellulose and many organic peroxides). with certain other materials.
2 Materials that must be moderately heated or 4-1.2 The violence of a reaction or decomposition of mate-
exposed to relatively high ambient temperatures p c„als can be increased by heat or pressure,or b� mixture tit
before ignition can occur. Materials in this degree certain other materials to form fuel-oxidizer combinations.
would not under normal conditions form hazard- or by contact with incompatible substances, sensitizing con-
ous atmospheres with air,but under high ambient taminants,or catalysts.
temperatures or under moderate heating might 4-1.3 Because of the wide variations of accidental combina-
release vapor in sufficient quantities to produce tions possible in fire or other emergencies. these extraneous
hazardous atmospheres with air.This includes: hazard factors (except for the effect of water) cannot be
I Liquids having a flash point at or above 100°F applied to a general numerical rating of hazards. Such
(37.8°C)and below 200°F(93.4°C)(i.e.,Class II and
Cl extraneous factors must be considered individually in order
Class IIIA liquids); - to establish appropriate safety factors,such as separation or
Solid materials in the form of coarse dusts that segregation. Such individual consideration is particularly
burn rapidly but that generally do not form explo- important where significant amounts of materials are to be
sive atmospheres with air; stored or handled. Guidance for this consideration is pro-
Solid materials in a fibrous or shredded form that vided in NFPA 49,Hazardous Chemicals Data.
burn rapidly and create flash fire hazards, such as
cotton,sisal,and hemp; 4-1.4 The degree of instability hazard shall indicate to fire
Solids and semisolids that readily give offflamma- fighting and emergency personnel whether the area shall be
ble vapors. evacuated, whether a fire shall be fought from a protected
♦ location, whether caution shall be used in approaching a
1 Materials that must be preheated before ignition spill or fire to apply extinguishing agents,or whether a fire
1 can occur.Materials in this degree require consid- can be fought using normal procedures.
enable preheating, under all ambient tempera-
ture conditions, before ignition and combustion 4-2 Definitions.
can occur.This includes:
4-2.1 For the purposes of this standard,an unstable material
Materials that will burn in air when exposed to
a temperature of 1500°F(815.5°C)for a period of is one that can enter into a violent chemical reaction with water.
5 min or less; Guidelines for determination of water instability hazard ratings
Liquids, solids, and semisolids having a flash can be found in Appendix D. Reactions with other materials
point at or above 200°F (93.4°C) (i.e., Class I IIB can also result in violent release of energy but are beyond the
1 liquids); scope of this standard.
Liquids with a flash point greater than 95°F 4-2.2 For the purposes of this standard,an unstable mate-
(35°C) that do not sustain combustion when rial is one that, in the pure state or as commercially pro-
tested using the Method of Testing for Sustained duced,will vigorously polymerize, decompose or condense,
Combustibility, per 49 CFR Part 173 Appendix H, become self-reactive,or otherwise undergo a violent chemi-
or the UN Recommendations on the Transport of Dan- cal change under conditions of shock,pressure,ortempera-
gerous Goods. 8th Revised Edition. ture. This calculation is not applicable for the evaluation/
Liquids with a flash point greater than 95°F classification of organic peroxides. Refer to NFPA 43B,Code
(35°C) in a water-miscible solution or dispersion for the Storage of Organic Peroxide Formulations, for more spe-
with a water noncombustible liquid/solid content cific information regarding the instability hazard rating of
of more than 85 percent by weight. organic peroxides. Guidelines for determining thermal sta-
Liquids that have no fire point when tested by bility ratings can be found in Appendix D.
ASTM D 92, Standard Test Method for Flash Point
and Fire Point try Cleveland Open Cup,up to the boil- 4-23 Stable materials are-those that normally have the
ing point of the liquid or up to a temperature at capacity to resist changes in their chemical composition,
which the sample being tested shows an obvious despite exposure to air, water, and heat as encountered in
physical change; fire emergencies.
Most ordinary combustible materials.
4-3 Degrees of Hazard.
0 Materials that will not burn. This includes any material that will not burn in air when exposed to 4-3.1 The degrees of hazard shall be ranked according to
a temperature of 1500°F(815.5°C)for a period of ease,rate,and quantity of energy release as follows:
5 min.
.4 Materials that in themselves are readily capable of
f. .gent v i r`y detonation or explosive decomposition or explo-
Chapter 4 Instability Hazards _ sive reaction at normal temperatures and pres-
sures.This includes materials that are sensitive to
4-1 General. localized thermal or mechanical shock at normal
temperatures and pressures.
4-1.1 This chapter shall address the degree of susceptibility Materials that have an instantaneous power
of materials CO release energy. Some materials are capable of density (product of heat of reaction and reaction
rapid release of energy by themselves, through self-reaction rate)at 482°F(250°C)of 1000 IN/mL or greater.
I
1996 Edition
704-8 IDENTIFICATION OF THE HAZARDS OF
MATFJt1A1S FOR EMERGENCY RESPONSE
3 Materials that in themselves are capable of deco- " 0 Materials that in themselves are normally stable,
nation or explosive decomposition or explosive even under fire conditions.This includes:
reaction, but that require a strong initiating Materials that have an instantaneous power
source or that must be heated under confinement I
density (product of heat of reaction and reaction
before initiation.This includes:
Materials that have an instantaneouspower rate)at 482°F(250°C)below 0.01 Want.;density (product of heat of reaction and reaction Materials that do not react with water;
rate)at 482°F(250°C)at or above 100 W/mL and Materials that do not exhibit an exotherm at
below 1000 W/m� temperature less than or equal to 932°F (500°C)
When tested by differential scanning calorimetn.
Materials that are sensitive to thermal or
mechanical shock at elevated temperatures and
pressures;
Materials that react explosively with water with- Chapter 5 "Special Hazards
out requiring heat or confinement.
I 5-1 General,
• 2 Materials that readily undergo violent chemical 5-1.1 This chapter shall address the other ro
change at elevated temperatures and pressures. material that specialcause properties of the
This includes: fighting techniques. problems or require special fire-
Materials that have an instantaneous power
density (product of heat of reaction and reaction
5.1.2 Special hazards symbols shall shown in the fourth
space of the diagram or immediately above or below the
rate)at 482°F (250°C) at or above 10 W/mL and entire symbol.
below 100 W/mL;
Materials that react violently with water or form 5-2 Symbols.
potentially explosive mixtures with water.
5-2.1 Materials that demonstrate unusual
reactivity with
water shall be identified by the letter W with a horizontal
1 Materials that in themselves are normally stable, line through the center(;K),
but that can become unstable at elevated temper- 5-2.2 Materials that possess oxidizing properties shall be
atures and pressures.This includes: identified by the letters OX.
Materials that have an instantaneous power
density (product of heat of reaction and reaction
rate)at 482°F(250°C)at or above 0.01 W/mL and
below 10 W/mL; Chapter 6 Identification of Materials by Hazard
Materials that react vigorously with water, but
not violently; Rating System
Materials that change or decompose on expo- 6-1 One of the systems delineated in the following illustra-
sure to air,light,or moisture. lions shall be used for the implementation of this standard.
Adhesive-backed plastic
background pieces,one Flammability White painted background,or
needed for each numeral, hazard rating— white paper or card stock
\I
three needed for each red
complete hazard rating Health Instability
- hazard rating—
hazard rating—
blue __ yellow/
I Figure 1 For use where specified Figure 2 For use where white color background is used with background 3 For use where wain
numerals of eontrastmg colors. is necessary, background is used with painted
numerals,or for use when hazard
rating is in the form of sign or placard.
Figure 6-1 Alternate arrangements for display of NFPA 704 Hazard Identification System
1996 Edison
0