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Tattoo and Body Piercing Establishment License Application
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Tattoo and Body Piercing Establishment License Application
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4/16/2025 12:10:39 PM
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Dept of Community Investment
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7 <br />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 • F: 574.235.9021 <br /> <br />LICENSE APPLICATION FOR – TATTOO & BODY PIERCING ESTABLISHMENT <br />MUNICIPAL CODE SECTIONS – 13-125 – 13-152 <br /> <br />V. INCLUDE WITH APPLICATION (Continued): <br />Insurance policy to contain the following provision: “The City of South Bend, through <br />the Office of the City Controller, will be given fifteen (15) business days’ notice prior to <br />the effective date of cancellation or other material change to this policy.” <br />M. Copies of proposed pre-service information and aftercare instructions to be used. <br />N. Proposed written policies to be used, in compliance with Municipal Code Sections 13- <br />125 – 13-152 and Indiana Occupational Safety and Health Administration's blood borne <br />pathogens standard that: <br />1. Require the use of universal precautions when performing any service <br />regulated by Article 13 that includes any reasonably anticipated skin, eye, <br />mucous membrane or parental contact with blood or OPIM. <br />2. Includes the safe and effective handling of infectious waste; and, <br />3. Provides sanctions, including discipline and dismissal, if warranted, for any <br />employee who fails to use universal precautions and/or handle infectious waste <br />in a safe and effective manner. <br />O. Copy of proposed infectious waste containment policies to be utilized, as well as copy of <br />proposed policies addressing treatment and transportation of infectious waste. <br /> <br />VI. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION <br /> <br />VII. AFFIRMATION <br /> <br />I, hereby, certify and affirm that all of the information I have given in this application is true and <br />accurate to the best of my knowledge. I further certify that I have in no way attempted to <br />mislead the City in this application by omitting facts known to me. I agree to cooperate with any <br />review conducted pursuant to the licensing procedures, including permission to enter and <br />inspect the place of business and facilities in conjunction with such a review. I have read and <br />understand the regulations Tattoo Establishments and Technicians found in the City of South <br />Bend Municipal Code, Sections 13-125 – 13-152. <br /> <br /> <br /> <br /> <br />Signature Date <br /> <br />PLEASE NOTE: Filing of new application for license does NOT authorize conducting Tattoo Artist <br />Business until such license has actually been issued to applicant.
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