ࡱ> uwt -bjbj ;r||2> ,,      8Xt m=^p(" <<<<<<<$?}B<- #cl ##<,,'=['['['#,( <L['#<['['86@8`f8C$86t<==0m=R8C$Cl88\C P9$ !['"l}" <<y& m=####C :  BIRMINGHAM CITY COUNCIL SCHEDULE 3 OF THE LOCAL GOVERNMENT (MISCELLANEOUS PROVISIONS) ACT 1982 Application for Variation of a Sexual Entertainment Venue Licence  Section 3 Section 6  Section 7 Please read the checklist below and tick to confirm you have enclosed all of the required information/documents; I have made or enclosed payment of the fee Please check the following link for details of the cost of your application:-  HYPERLINK "http://www.birmingham.gov.uk/licensingfeesandcharges" http://www.birmingham.gov.uk/licensingfeesandcharges I enclose a plan showing the interior layout and where relevant entertainment will take place I have enclosed a copy of the club rules.  I have enclosed a scheme showing the exterior design of the premises I understand and agree that I must send a copy of my completed application to the Chief Officer of Police no later than seven days after the date of the application. I also understand that I must produce evidence of due service of the Notice of Application upon the Chief Officer of Police as required by paragraph 10(14) of the Third Schedule of the Local Government (Miscellaneous Provisions) Act 1982. I understand that I must now advertise my application on or near the Premises for 21 days starting with the date of the application. I understand that I must advertise the application in a local newspaper within seven days after the date of the application and that a copy of the notice of application which has been published must be given to the Licensing Authority. DECLARATION: I declare that the details in this application are true to the best of my knowledge and belief and acknowledge that if there are any omissions or incorrect statements of a serious nature this may result in the application being refused. I further declare that I have read and agree to abide by the conditions of Licence for a Sexual Entertainment Venue made by ² in accordance with Section 2 Schedule 3 of the Local Government (Miscellaneous Provisions) Act 1982 should my application be granted. APPLICANTS ARE INFORMED THAT ANY PERSON WHO, IN CONNECTION WITH AN APPLICATION FOR THE GRANT, RENEWAL OR TRANSFER OF A LICENCE, MAKES A FALSE STATEMENT WHICH HE KNOWS TO BE FALSE IN ANY MATERIAL RESPECT OR WHICH HE DOES NOT BELIEVE TO BE TRUE, IS GUILTY OF AN OFFENCE AND LIABLE, ON SUMMARY CONVICTION, TO A FINE NOT EXCEEDING 20,000. Signature Name of Signatory . Designation of Signatory .. Date .. NOTE: Your application should be determined within 60 days of receipt of all the information necessary for the Council to process and determine the application. (Please note that this will be subject to any Licensing Committee hearings) In the case of an incomplete application form, the Licensing Section will contact you for additional information to enable the application to be processed. Please refer to the Councils policy for Sexual Entertainment Venues which can be viewed via the Councils website. Tacit Consent will not apply as it is in the public interest that the authority must process your application before it can be granted. If you have not heard from the Council within a reasonable period of time, please contact us using the contact details below. THE NOTICE OVERLEAF MUST BE PUBLISHED IN A LOCAL NEWSPAPER CIRCULATING WITHIN BIRMINGHAM, NO LATER THAN 7 DAYS AFTER THE DATE OF YOUR APPLICATION. THE NOTICE OVERLEAF, OR ONE IN A SIMILAR FORM, MUST BE DISPLAYED CONTINUOUSLY, ON THE PREMISES TO BE LICENSED, FOR A PERIOD OF 21 DAYS BEGINNING WITH THE DATE OF YOUR APPLICATION ON OR NEAR THE PREMISES AND IN A PLACE WHERE THE NOTICE MAY CONVENIENTLY BE READ AT ALL TIMES BY THE PUBLIC PASSING BY. ² General Licensing Regulation & Enforcement P.O. Box 17831 BIRMINGHAM B2 2HJ 0121 303 9896  HYPERLINK "mailto:licensing@birmingham.gov.uk" licensing@birmingham.gov.uk www.birmingham.gov.uk/licensing CERTIFICATE (To be completed by all applicants) I certify that a copy of the notice overleaf was displayed on the premises to be licensed, on or near the premises, in a place where the notice may conveniently be read by the public, for a period of ..days, From (date) to (date) .. Signature of applicant ...... Date . NOTE: THIS FORM MUST BE COMPLETED, SIGNED AND RETURNED TO THE LICENSING SECTION, AT THE ADDRESS OVERLEAF. YOU SHOULD ALSO ATTACH A COPY OF THE NOTICE WHICH APPEARED IN A LOCAL NEWSPAPER, CIRCULATING WITHIN BIRMINGHAM, TO THIS FORM.       SEX ENT 3.3 PAGE  PAGE 1 Fair Processing Statement Any personal data held by ² in relation to your application for a Licence to use a premises, vehicle, vessel or stall as a Sexual Entertainment Venue, will be held in full compliance with the legal obligations as set out in the Data Protection Act 1998. This is in accordance with the Councils Privacy Policy; a copy is available on the Councils website:  HYPERLINK "http://www.birmngham.gov.uk/privacy" www.birmingham.gov.uk/privacy. To protect the public fund we may also use the information you have provided on this form to prevent and detect fraud. We may share this information for the same purposes with other Council Departments and organisations for example, other councils and the police. Premises, Applicant and contact details: Licensed Name of Premises.. Full Address of Licensed Premises... . Telephone Number .. Name of Applicant............................................................................................................................ (NB this must be the current licence holder) Full Address of Applicant Telephone Number (during normal office hours) Name and Address to which correspondence to be sent (if different from above) . . Contact Telephone Number (during normal office hours). Contact e-mail address . Variation details: When do you want the variation to take effect? ................................................................... Please detail the proposed variation (enclose supporting documents if relevant) .. .. .. .... Is there any information in this application which you would not wish to be seen by members of the public? Yes o No o If yes, state which information and the reasons why you would not wish it to be seen & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & & Is there any further information which the Applicant would wish the Council to take into account when considering this application? .. .. .. LOCAL GOVERNMENT (MISCELLANEOUS PROVISIONS) ACT 1982 SECTION 2, SCHEDULE 3: CONTROL OF SEX ESTABLISHMENTS Notice of Application for Variation of a Sexual Entertainment Venue Licence NOTICE IS HEREBY GIVEN THAT I, (full name) APPLIED ON (date) TO BIRMINGHAM CITY COUNCIL, IN RESPECT OF THE PREMISES KNOWN AS . OF . (address) UNDER THE LOCAL GOVERNMENT (MISCELLANEOUS PROVISIONS) ACT 1982, TO VARY THE EXISTING SEXUAL ENTERTAINMENT VENUE LICENCE AS INDICATED BELOW:- . . . ANYONE WISHING TO MAKE OBJECTIONS TO THIS APPLICATION MUST DO SO IN WRITING TO: NO LATER THAN 28 DAYS AFTER THE DATE OF THE APPLICATION, STATING THE GROUNDS FOR OBJECTION. BIRMINGHAM CITY COUNCIL GENERAL LICENSING REGULATION & ENFORCEMENT P.O. BOX 17831 BIRMINGHAM B2 2HJ Email address  HYPERLINK "mailto:licensing@birmingham.gov.uk" licensing@birmingham.gov.uk   *+=rtuƼݭ|l`QEh756>*CJaJh>zh>z56>*CJaJh|56>*CJaJjhmCJUmHnHuhmWh`hZaJ haJh`haJ haZaJh`h aJ h oCJ h CJhZ h 5h CJOJQJh 5>*CJOJQJh CJOJQJh h 5CJOJQJ&jh CJOJQJUmHnHu  *+ru ]^$]^a$gd]gd` ]^ $]^a$]dh$a$ ]^          7]^gd'O 7]^gdo ]^  , - . 5 6 7 8 9 @ Ǽvg[MI=h%h;5CJaJhuhh.hk56CJaJhF 56>*CJaJhkh2 i56>*CJaJh"56>*CJaJhk5>*CJaJ h6CJh h'Ojh7 UmHnHuh'OCJaJhoh'OCJaJh756CJaJhkhcdV56CJaJh756>*CJaJhkhcdV56>*CJaJhkh|56>*CJaJ                   ! 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