Interim authority notice under the Licensing Act 2003

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To: South Somerset District Council, being the Licensing Authority
Of: The Council Offices, Brympton Way, Yeovil, Somerset, BA20 2HT

I/we (name of applicant):
Name:
give this interim authority notice under section 47 of the Licensing Act 2003 for the premises described in Part 1 below
Premises licence number (if known):

Part 1 - Premises details

Do you know the address of the premises? *