JANUARY 2014 For Office use only LOCAL GOVERNMENT (MISCELLANEOUS PROVISIONS) ACT 1982 APPLICATION FOR A STREET TRADING CONSENT Before submitting an application you should read Stroud District Council’s ‘Street Trading Factsheet’ available on our website www.stroud.gov.uk. 1. Type of Application NEW 12 MONTH CONSENT OTHER PERIOD (Please specify) STATIC (FIXED) BAND 1 6 MONTH CONSENT (Please specify which months) ITINERANT (MOBILE) BAND 2 2. Applicant Details FULL NAME: PERMANENT ADDRESS: CONTACT TELEPHONE NUMBERS: EMAIL: DATE OF BIRTH: NI NUMBER: Are you eligible to work in the United Kingdom? Yes 1 My UNI-form.url JANUARY 2014 No JANUARY 2014 3. Trading Location Where is it proposed that the trading will take place? Please give precise details. If this location is on private land can you provide documentary evidence that you have the landowners’ permission to trade from their land? Yes No 4. Trading Hours. Please indicate which days of the week and hours of the day you wish to trade. Mon Tues Wed Thurs Fri Sat Sun From To 5. Description of the articles to be sold or offered for sale. If selling foodstuffs, are you registered with the relevant local authority to carry on a food business? Yes Details of any person(s) who will be assisting with the street trading Full Name: 2 My UNI-form.url JANUARY 2014 No JANUARY 2014 Address: Date of Birth: NI No: Full Name: Address: Date of Birth: NI No: (continue on a separate sheet if necessary) 6. Description of street trading unit Please provide the vehicle/towing vehicles registration no: Ground dimensions of proposed unit/site Address where the street trading unit will be kept when not being traded from Please detail toilet facilities for persons working on a static site: 7. Previous Applications/Licences/Consents Have you ever been refused a street trading licence or consent or had such a licence or consent revoked? Yes No 3 My UNI-form.url JANUARY 2014 JANUARY 2014 If yes, please give details (continue on a separate sheet if necessary) 8. Declaration I certify the statements made in this application are true to the best of my knowledge and belief. On grant of a licence I undertake to comply with Stroud District Council’s policy and conditions for street trading consents I confirm that I am legally entitled to work in this Country I consent to Stroud District Council retaining and processing my personal data in accordance with the statements below. I understand that if I fail to comply with the application requirements listed below, my application will be rejected. Signed …………………………………………………….… Date ……………………………......…. Stroud District Council is a registered Data Controller for the purposes of the Data Protection Act 1998. We will process your personal data in accordance with that Act. We will use the information you have provided on this application form to assess the suitability of the vehicle as a hackney carriage or for private hire and for administration and management purposes. We may disclose the information to external agencies for crime prevention purposes and statistical analysis. If your application is unsuccessful, we will keep your information for a reasonable period in accordance with legal requirements and for administration purposes. This authority is under a duty to protect the public funds it administers, and to this end may use the information you have provided on this form for the prevention and detection of fraud. It may also share this information with other bodies responsible for auditing or administering public funds for these purposes. For further information, see Stroud District Councils website www.stroud.gov.uk using the following link http://www.stroud.gov.uk/docs/democ/data_matching.asp or contact Michael Nadin in Internal Audit by email on: michael.nadin@stroud.gov.uk or by telephone on: 01453 754122 9. Application Requirements This application must be accompanied by the following documents: a plan (where appropriate) showing the trading location a passport sized photograph of all working on unitc Photograph of trading unit a copy of my third party public liability insurance Proof of eligibility to work (National Insurance Details) A valid basic disclosure certificate – please see page 9 of Stroud District Council’s Street Trading Policy Documentary evidence of the landowners permission (where necessary) to trade from their land 4 My UNI-form.url JANUARY 2014 JANUARY 2014 LICENSING SECTION CONTACT DETAILS Licensing Section, Stroud District Council, Ebley Mill, Westward Road, Stroud, GL5 4UB Tel 01453 754440 Fax 01453 754963 Email licensing@stroud.gov.uk Web www.stroud.gov.uk LOCAL GOVERNMENT (MISCELLANEOUS PROVISIONS) ACT 1982 NOTICE OF INTENTION TO APPLY TO STROUD DISTRICT COUNCIL FOR THE GRANT OF A STREET TRADING CONSENT Full Name of Applicant(s) ………………………………………………………………………………………………………….. ………………………………………………………………………………………………………….. Location of Proposed Street Trading Site: (map attached) Articles to be sold or offered for sale: 5 My UNI-form.url JANUARY 2014 JANUARY 2014 Description of street trading unit including ground dimensions of proposed unit/site Proposed trading hours. Mon Tues Wed Thurs Fri Sat Sun From To Proposed commencement date (if consent is granted) ……………………………………………………………………. Signature of Applicants: ………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………. Date: …………………………………… 6 My UNI-form.url JANUARY 2014