APPLICATION FOR A VARIATION TO A PREMISES LICENCE UNDER THE LICENSING ACT 2003 Statement of the relevant licensable activities which it is proposed will be carried on or from the premises: Variation is to add the sale of alcohol as a licensable activity for consumption off the premises Name of Applicant: Top Star Food Ltd Full postal address of premises: Chicken Palace, 90-92 Portland Road, South Norwood, SE25 4PJ Postal address of local authority where register of applications is kept for general viewing: London Borough of Croydon, Place Department, Licensing 6th Floor Zone A, Bernard Weatherill House, 8 Mint Walk, Croydon, CR0 1EA. Application details can be viewed at Access Croydon, Bernard Weatherill House, between 9am - 3.45pm, Monday to Friday (except bank holidays) If you wish to make any representations in relation to this application, please do so in writing by midnight on Thursday 1st April 2021 to the following address: London Borough of Croydon Place Department, Licensing Team, 6th Floor, Zone A Bernard Weatherill House 8 Mint Walk Croydon, CR0 1EA Or By Email to: [email protected] It is an offence to knowingly or recklessly make a false statement in connection with an application. The maximum fine on summary conviction for such an offence is £5000. Continued from previous page... See guidance on regulated entertainment Will the schedule to provide indoor sporting events be subject to change if this application to vary is successful? Yes No Section 7 of 18 PROVISION OF BOXING OR WRESTLING ENTERTAINMENTS See guidance on regulated entertainment Will the schedule to provide boxing or wrestling entertainments be subject to change if this application to vary is successful? Yes No Section 8 of 18 PROVISION OF LIVE MUSIC See guidance on regulated entertainment Will the schedule to provide live music be subject to change if this application to vary is successful? Yes No Section 9 of 18 PROVISION OF RECORDED MUSIC See guidance on regulated entertainment Will the schedule to provide recorded music be subject to change if this application to vary is successful? Yes No Section 10 of 18 PROVISION OF PERFORMANCES OF DANCE See guidance on regulated entertainment Will the schedule to provide performances of dance be subject to change if this application to vary is successful? Yes No Section 11 of 18 PROVISION OF ANYTHING OF A SIMILAR DESCRIPTION TO LIVE MUSIC, RECORDED MUSIC OR PERFORMANCES OF DANCE See guidance on regulated entertainment Will the schedule to provide anything similar to live music, recorded music or performances of dance be subject to change if this application to vary is successful? Yes No Section 12 of 18 PROVISION OF LATE NIGHT REFRESHMENT © Queen’s Printer and Controller of HMSO 2009 .