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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 14005 -South Bend, Indiana 46601 - 574.235.5912 - F:574.235. t C', <br />i I <br />LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT <br />MUNICIPAL CODE SECTION - 4-35 <br />I. APPLICATION'TYPE CheckOne: New <br />Il. BUSINESS DATA <br />A. Business Name: THERAPEUTIC INDULGENCE LLC <br />Renewal XXX <br />B. Business Address: 90'3 E. JEFFERSON BLVD. <br />City: SOUTH' BEND State: IN Zip: 46617 <br />C. Mailing Address (If different from above): <br />City: — — State: Zip: <br />D, Business Telephone Number: 574-520-1664 <br />E. Business Fax Number: <br />F. E-Mail Address: THERAPEUTICINDULGENCE@GMAIL.COM <br />G. Zoning of Business Location. MU <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 <br />1. If yes, what was the reason: <br />1 If yes, what was the business occupation following the suspension/revocation: <br />I. Describe the nature and scope of the business: <br />C e -7mmx . . ...... L.- <br />For Office Use Only <br />Application Filed MAR 0 1 2018 Public Safety Approval <br />Application Fee Paid HV AH 0 1 2018 License Fee Paid <br />FAR 0 1 2018 - -- A Sent to Dept. License Number 16 P50 <br />Not Approved of pjj�jlv <br />Reason <br />