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For all municipal business license questions, contact: City of South Bend - Department of Community Investment <br />227 West Jefferson Blvd - Suite 1400 S -South Bend, Indiana 46601 - 574,235.5912 - R 574,235.9021 <br />.9 o <br />LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT <br />1. APPLICATION TYPE Check One: <br />11, BUSINESS DATA <br />� 0 ra WTA <br />A. Business Name: HAIR GRAFTERS <br />B. Business Address: 602 LINCOLN WAY E. <br />City: SOUTH BEND <br />C. Mailing Address (if different from above): _ <br />City: <br />State: IN <br />State: <br />D. Business Telephone Number: 574-288-2448 <br />E. Business Fax Number: 574-233-8370 ___ <br />F. E-Mail Address: E,DEWINTER@SBCGLOBAL. NET <br />Renewal XXX <br />Zip: 46601 <br />Zip: <br />G. Zoning of Business Location: LB <br />H. Have you ever had a Massage Establishment license, or similar license, suspended or revoked <br />by any governing municipality within three (3) years prior to the date of this application: <br />YES N 0 <br />1, If yes, what was the reason: <br />2. If yes, what was the business occupation following the suspension/revocation: <br />I. Describe the nature and scope of the business: FUZZ 5 -e-[^ 0 ;C e -Sak, <br />r'; L)q rK _'� 1_11j( <br />alX 4 c' Qre'�P"� <br />For Office Use Only <br />FEB 2 6 2018 <br />Application Filed Public Safety royal <br />AppB 2 6 2,018 <br />Application Fee Paid FEB 2 6._jjfla_ License Fee Paid <br />Sent to Dept, E L-B 9 License Number <br />Not Approved <br />Reason <br />1 <br />