Laserfiche WebLink
For all municipal business license questions, contact: City ofSouth Bend - Department Of Community investment <br />227 West Jefferson Blvd - Suite 1400S -South Bend, Indiana 46601 - 574.235.5912 - F. 574.235.9021 <br />LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT <br />MUNICIPAL CODE SECTION - 4-35 <br />I. APPLICATION TYPE Checl(One: New Renewal XXX <br />II. BUSINESS DATA <br />A. Business Name: TOP ORIENTAL MASSAGE <br />B. Business Address: 421 HICKORY RD. <br />City: SOUTH BEND <br />C. Mailing Address (if different from above): <br />City: SOUTH BEND <br />D. Business Telephone Number: — <br />E. Business Fax Number: <br />State: IN <br />5569 BUCKHORN DR. <br />F. E-Mail Address: ia.6e_(6twrt;k (A- <br />State: IN <br />Zip: 46615 <br />Zip: 46614 <br />G. Zoning of Business Location: CB - <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 NO X. <br />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: m A ss- A6.r=. -f -4e 44P V <br />ALLO W F—b (ND F—P-- A UPPLA CA517�—A--T—�, Ctl_Ys <br />UqTq Affl) ()PT'>jAA 7 to 5. <br />For Office Use Only <br />Application Filed FEB 2 7 2018 Public Safety Approval TEB 2 7 ZU1,1 <br />Application Fee Paid FEB 2 7 2013 License Fee Paid <br />Sent to Dept. FEB 2 7 2013 License Number Ze— -7 17 44 <br />Not Approved <br />Reason IAR P 7 <br />1 <br />