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Home My WebLink AboutMassage Establishment - South Bend Massage and HealingINTER -OFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE SENT: 2/1/2018 TO: �Vederico Rodriguez, Fire Department XLarry Magliozzi, Area Plan Angela Smith, Area Plan lames Burns, Police Department raaent 5(Chris Dressel, Community Investment FROM: Linda M. Martin, Clerk ,+ NEW - MASSAGE ESTABLISHMENT LICENSE SUBJECT: RECOMMENDATION -South Bend Massage & Healing LOCATION: 115 N. William St DATE DUE: Februa 6 2018 FAX OR E-MAIL TO: 235-9171 1 lmartin(a7southbendin.gov RECOMMENDATIONS AND COMMENTS: By Date For all municipal business I loense questions, contact; City of South Bend - Department of Community Investment 227 West Jefferson Blvd -Suite 1400S -South Bend, Indiana 46601 -574.235,5912 - F:5�4,235.9021 0 Rkc' QQ. 5 1 � qW") 1-1 1 MUNICIPAL CODE SECTION - 4-35 1, APPLICATION TYPE Check One: New X Renewal [I. BUSINESS DATA A. Business Name: South Bend Massage & Healing B. Business Address: 115 N. William St. _ city: South Bend State: IN -Zip: 46601 C. Mailing Address (If different from above): City: State: D. Business Telephone Number. 574-261 -8500 E. Business Fax Number: F. E-Mail Address: info@southbendmassage.com zo G. Zoning of Business Location: MU -Mixed Use (See Attached) H. Have you ever had a Massage Establishment license, or similar license, suspended or revoked by any governing municipality within three (3) years prior to the date of this application: YES NO X 1, If yes, what was the reason: 2. If yes, what was the business occupation following the suspension/revocation: I. Describe the nature and scope of the business: Perform therapeutic massage services: includes relaxation massage, hot stone massage, deep tissue & medical massage, prenatal massage, and reflexology, all of which"I am licensed for in the state of Indiana, City of South Bend, and St. Joseph County. Application Filed JAN 9, 9 2018 Public Safety Approval Application Fee Paid jAl lo License Fee Paid JAN 29 2018 Sent toDept. . _JANI 9-)III 8- License Number -.--- Not Approved A I" P 4 0.,V Up Board Of 13111b1k, Reason M A D rr4n 0 For all municipal business license questions, contact: City of South Bend • Department of Community investment 227 West Jefferson Blvd a Suite 1400 5 -South Bend, Indiana 46601 a 574.235.5917 o F: 574.235.9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-3S 11), OWNERSH)P A. Type of ownership (check one): x Sole Proprietorship (if sole proprietorship, proceed to 1). Partnership (if partnership, proceed to 2). Corporation (if corporation, proceed to 3). 1. Sale Proprietor Name: Dena M. Woods Residential Address, 20807 Wellesley Ct. city: South Bend State: IN Zip: 43637 2. Partnership (List at least two (2) partners) Name #1: Residential Address: City: Dame #2: Residential Address: City: 3. Corporation State: Zip: State: Zip: Legal name of corporation: South Bend Massage, LLC Date and state of incorporation: 1 /1 /18 List officers and directors who own 15% or more of stock: Name #1: Title: Business Address: City: Residential Address: State: Zip: City: State: Name #2: Title: Business Address: City: Residential Address: City: V Zip: State: Zip: State: Zip: For all municipal business license questions, contact; City of South Bend -Department of Community Investment 227 West Jefferson Blvd a Suite 1400 5 -South Bend, Indiana 4660I ® 574,235.5912 e F: 574.235.9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION -4-35 IV. PERSONAL DATA (Continued) N. Photographs: Attach below (3) Passport photos, l"xi", taken within 6 months of the date of this application. 903 E. Jefferson E3Ivd. South Bend, IN 4uti1 i r&u 1-7 - I �Izu 4 r (Attach additional sheets if necessary) V. INCLUDE WITH APPLICATION: Three (3) passport photos taken within 6 months of application. VI. INCLUDE $5.00 PROCESSING FEE WITH APPLICATION VII. AFFIRMATION 1, hereby, certify and affirm that all of the information I have given in this application is true and accurate to the best of my knowledge. I further certify that I have in no way attempted to mislead the City in this application by omitting facts Known to me. I agree to cooperate with any review conducted pursuant to the licensing procedures, including permission to enter and inspect the place of business and facilities in conjunction with such review. I have read and understand the regulations of the Massage Establishment and/or Therapist license found in the City of South Bend Municipal Code, Section 4-35. Signature 4 Date NOTICE OF PUBLIC HEARING ON APPLICATION FOR MASSAGE ESTABLISHMENT LICENSE Notice is hereby given to all interested individuals that the Board of Public Works of the City of South Bend, Indiana, will conduct a Public Hearing at 9:30 a.m. on Tuesday, March 27, 2018 in the Board of Public Works Room, Ste. 1308, 13th Floor, County -City Building, South Bend, Indiana, on the application for a new License Application for a Massage Establishment for South Bend Massage & Healing, 115 N. William St., South Bend, IN 46601. Interested persons may be heard on this matter at the Public Hearing or may file with the Board of Public Works a Memorandum in support of or in opposition to the issuance of such license. BOARD OF PUBLIC WORKS Linda M. Martin, Clerk Publish one (1) time: March 23, 2018 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND. INDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIF-G, MAYOR BOARD OF PUBLIC WORKS March 19, 2018 Ms. Dena M. Woods 20807 Wellesley Ct, South Bend, IN 46637 RE: Public Hearing -- License Application for Massage Establishment Dear Ms. Woods: PHONE 574/235-9251 FAX 574/ 235-9171 . The Board of Public Works is in receipt of your License Application for a Massage Establishment at 115 N. William St., South Bend, IN. Pursuant to the City of South Bend license ordinance requirements, a Public Hearing on the application must be conducted by the Board. The Board of Public Works has set the Public Hearing for 9:30 a.m., Tuesday, March 27, 2018 in the Board of Public Works Room, Suite 1308,13th Floor, County -City Building, South Bend, Indiana. You, or your designee, must be present to answer questions with regard to the proposed business activity. If you have any questions, please call me. Sincerely, Dv( - LiMa M. Martin, Clerk Enclosure c: Michelle Adams, Licensing GARY A. G1LOT SuzANNA M. FR1TzRERG ELIZABETH A. MARADIK JAMEs A. WELLER THERESE J. DORAu ctcleof Indiana Certificate of Organimflon O: SDLUH BEND 1, CONNIE LAB, S)cretary of aatB, hereby certify that Atides of Orgmization of the zbove Domesfic Limited UaNlity Cbmpany have; tE�, pt'e8ented to me cl ray office, mpanled by the fees prescribed by law and that the. documentation presented f6rs to law as prescribed by the prosalslons of the Indiana Wsiness Re)(JUcity Ad. NOW, THBlffDM with this document I certify t.W said transaction will become effective Monday, . teary 81, 2018. In Witness Whereat, t haw rt-ed to be affixed my signature and the sed of the ;tale of Indiana, a the aty of Indiaiapolts, Deuember 08, 2017 f � / 2018G 101122711717774147 To erasure the ceMficate's ve idity. go to https://b . in.gc)vlPublicBu.sirzess.%a ch APPROVED AN D FILED CONNW,—L.AWSON INDIANA SECRETARY Off' STATE 121081201710:37 AM Formed pursuant to the provisions of the Indiana Business Flexibility Act ARTICLE J - NAME Al ) P.R1 lCIP AL'0F.nCE ADDRESS BUSINESS ID 201801011227117 BUSINESS TYPE Domestic Limited Lia>>ility Company BUSINESS NAME SOUTH BEND MASSAGE LLC PRINCIPAL 0 ,, CE ADDRESS 115 N. William Street, South Bend, IN, 46601, USA ARTICLE II - REGISTERED OFFICEA1 D 1011 SS - NAME ADDRESS Dena M Woods 20807 Wellesley Ct., South Bend, IN, 46637, USA ARTICLE, ` i - PERIOD OIt DURATION AND - 4 + + CTIVE.DATE PERIOD OF DURATION Perpetual ECTIVE DATE 01101/2018 ]EMCTIVE TIME 12:01AM ARTICLE.",!. PRIITCIPAL(S) TITLE ^Manager NAME ADDRESS MANAGEMENT I14MRMATION: Dena Marie Woods 20807 Wellesley Ct., South Bend, IN, 46637, USA THE LLC WILL BE MANAGED BY MANAGERS) Yes SINGLE MEMBER LLC - Page 1 Of 2 - APPROVED AND FILED CONNIE LAWSON 1NDIANA SECRETARY OE STATE 12108/2017 1037 AM � THE SIGNATOR(S) REPRESENTS THAT THE REGISTERED AGENT NAMED IN THE APPLICATION HAS CONSENTED TO THE APPOINTMENT OF REGISTERED AGENT. THE UNDERSIGNED, DESIRING TO FORM A LEVJITED LIABH-3TY COMPANY PURSUANT TO TIIE PROVISIONS OF THE INDIANA BUSINESS FLEXIBILITY ACT EXECUTES THESE ARTICLES OF ORGANIZATION. IN WITNESS WHEREOF, THE UNDERSIGNED HEREBY VERIFIES, SUBJECT TO THE PENALTIES OF PERJURY, THAT THE STATEMENTS CONTAINED HEREIN ARE TRUE, THIS DAY December 7, 2017 SIGNATURE, Dena M Woods TITLE ` Agent Business ID: 201801011227117 Filing No: 7774147 -Page2of2- TJOSEP CITY OF SOUTH BEND December 1, 2017 Dena Woods 115 N William St South Bend, M 46601 RE: Zoning verification for property located at 115 N William St, South Bend, IN 46601 (Parcel ID# 018-1023-0965) Dear Ms. Woods, In response to your request for verification on the designated zoning of the property located at 115 N William St, South Bend, IN 46601 (Parcel ID# 018-1023-0965) we have found the following: 1. CURRENT ZONING: The property identified above is zoned MU —Mixed Use District. 2. PERMITTED USES: Massage Establislunents are a permitted primary use in MU districts, and on the above noted property. The information provided in this letter is in response to the specific information requested and does not necessarily represent all of the restrictions and allowances applicable to the property identified in this letter. Sincerely, 4ek Ayoka Pack, MCIP, AICP Zoning and Business Services Administrator FXCE.t.ENCE i ACCOUNIAMILITY i 1NNOV� ION I N C€.USIOii ? <'.� S, �fsya�ae u14�#. i e.}:ir: � � �cu'r�`:� fi r,�ai�v�a �G•c�='> i R `;: �.'.�t� a r,� £ � 57.+.'7:I 3„�s1 i t ;=r�zsw,LA,tM;�is-F�Fr r SOUTI ALING South Bend Massage and dealing will be a business that provides therapeutic massage services including relaxation massage, hot stone massage, prenatal massage, deep tissue massage, and reflexology. All sessions will be performed by Dena Woods, LMT1Owner/Sole Proprietor. Dena Woods is licensed to perform massage therapy in the City of South Bend, St. Joseph County, and the State of Indiana. Services will be provided during listed business hours at proposed location of 115 N. William St. South Bend, IN 46601. All sessions will be performed in accordance with the City of South Bend Municipal Code Section 4-35 and St. Joseph County Code 113. For further questions on the nature of this proposed business or scope of practice, please contact owner, Dena Woods at 574-261-6500 or info@southbendmassage.com. Do not reply to this email, it is not a monitored account Professional Licensing Agency Eric J. Holcomb 402 West Washington Street Governor of Indiana Room W072 _ _- Deborah J. Frye Indianapolis, Indiana 46204 IPLA Executive Director Your Massage `therapist (license, permit, or registration) has been issued by the Indiana Professional Licensing Agency. You have been assigned number MT21706035. The issue date is 03/01/2017 and it will expire on 05/1512021. If you were issued a controlled substance registration (CSR), please registerfor your INSPECT account. More information about INSPECT can be found at www.11VSAECT_in.gov . Verify Your License Online Your license can be verified online using the free public Search & Verify site. Order License Cards The Indiana Professional Licensing Agency no longer issues pocket license cards or wall certificates as part of the licensing process. If your profession has a posting requirement, or if you would like a license card, please read the following information. • License Cards; License cards are available to order through the MVLicense Online Licensing Service. You may pay with your Visa, Discover, or MasterCard credit/debit card. You also have the option to print your own free paper certificate. The free paper certificate meets all posting requirements. • Individuals: Your Login ID is your primary license number and your password is the last 4 digits of your social security number. • Businesses, facilities, and companies: Your license number is both your login ID and your password. • Fees: The fee to order a wallet card and wall certificate combo is $13.77 per card ($10 fee plus $3.77 in additional processing fees). Some professions have the choice of ordering a card with or without an expiration date. • Pharmacy, Dental, Barber, Funeral, Cosmetology, & Plumbing Professions: Indiana law requires that you have a license card posted in your place of business. You must order a license card to practice your profession. Both versions of the card meet the posting requirement. Information For additional information regarding your profession and other available services, please visit the agency website, www.vIa.in.gov. Contact information is available for each licensing board by selecting the Find Your Profession link. Indiana Professional Licensing Agency Do not reply to this email, it is not a monitored account. Cie a H V N c o o U o chi 3 Cd C�121bA DO 94 bfl • 0 10. i T U :'� a rUr! U MEdo p 4 v, U bl) Cd -'0.) .OH 3 0 0 N �y� o H O Cd E U U. N •cd ,.6 U C., A �" O cd M ko 0 m � h1 rN O U on 0 a w d o •a � 7 Tn p cd +o o C ?-. o Y 't1 z• U O p U i•. rU.+ � - 0, w 4,1 z �ryq o Ei b, N c7 O S. •J-� iy �"� bo A w � "o W N y t.a y TSON + r REM W E AT PERFOM77 �I cn E cl cl F x c d! � as V] a_ m • i �„� _ � _ -.I' cam. - Aq�q y�qR MY 1ura •J F (!1 � d co ID. ._ .. ID iL7.± y .. -.. cu 'Am a n Z. Pul . . ... ... . . .... ...... ;� h 1B8l1INP�� .. . .. .. ... 4V ev, .. 1316 COUNTY -CITY BUILDING 227 W.JEFFERSON BOULEVARD SOUTH BEND. 1NDIANA 46601-1830 CITY OF SOUTH BEND PETE BUTTIGIEG, MAYOR BOARD OF PUBLIC WORKS March 19, 2018 Ms. Dena M. Woods 20807 Wellesley Ct. South Bend, IN 46637 RE: Public Hearing -- License Application for Massage Establishment Dear Ms. Woods: PHONE 574/235-9251 FAx 574/235-9171 The Board of Public Works is in receipt of your License Application for a Massage Establishment at 115 N. William St., South Bend, IN. Pursuant to the City of South Bend license ordinance requirements, a Public Hearing on the application must be conducted by the Board. The Board of Public Works has set the Public Hearing for 9:30 a.m., Tuesday, March 27, 2018 in the Board of Public Works Room, Suite 1308,13th Floor, County -City Building, South Bend, Indiana. You, or your designee, must be present to answer questions with regard to the proposed business activity. If you have any questions, please call me. Sincerely, a� �L- -)4t Li da M. Martin, Clerk Enclosure c: Michelle Adams, Licensing GARY A. GILOT SUZANNA M. FRITZBERG ELIZABETH A. MARADIK JAMES A. MUELLER THERESE J, DORAu APPLICATION FOR MASSAGE ESTABLISHMENT LICENSE Notice is hereby given to all interested individuals that the Board of Public Works of the City of South Bend, Indiana, will conduct a Public Hearing at 9:30 a.m. on Tuesday, March 27, 2018 in the Board of Public Works Room, Room 1308, 13th Floor, County -City Building, South Bend, Indiana, on the application for a new License Application for a Massage Establishment for South Bend Massage & Healing, 115 N. William St, South Bend, IN 46601. Interested persons may be heard on this matter at the Public Hearing or may file with the Board of Public Works a Memorandum in support of or in opposition to the issuance of such license. BOARD OF PUBLIC WORKS Linda M. Martin, Clerk Publish one (1) time: March 23, 2018