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HomeMy WebLinkAboutLicense - Massage Establishment Renewal - King Asian Massage1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 PHONE 574/235-9251 FAx 574/235-9171 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS April 25, 2023 Ms. Jing Wang King Asian Massage 914 S. Ironwood Dr. South Bend, IN 46615 Jingwan 03�29kgmail.com RE: Approval — License Renewal for New Massage Establishment Dear Ms. Wang: At its April 25, 2023 meeting, the Board of Public Works approved your request for the New Massage Establishment at 914 S. Ironwood Dr. If you have any further questions, please call this office at (574) 235-9251. Sincerely, Is/ Theresa Heffner Theresa Heffner, Clerk Enclosures TH/lh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT JORDAN V. GATHERS MURRAY L. MILLER INTEROFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE: 03/07/2023 TO: Brad Rohrscheib, Police Department St. Joseph County Health Department - see attached Gerard Ellis, Fire Department Angela Smith, Zoning Department FROM: Theresa Heffner, Clerk SUBJECT: RENEWAL - MASSAGE ESTABLISHMENT LICENSE RECOMMENDATION BUSINESS NAME: KING ASIAN MASSAGE ADDRESS: 914 S. IRONWOOD DR. PLEASE INSERT YOUR RECOMMENDATIONS IN THE APPROPRIATE FIELD BELOW, BASED ON THE FOLLOWING CRITERIA FROM MUNICIPAL CODE SEC. 4-35: 1. The applicant and his/her partners have not been convicted of any crime involving unlawful deviate conduct, deviate sexual conduct, or unlawful sexual conduct within three (3) years prior to the date of application. (Verified by PD). 2. The applicant is a minimum of 18 years of age. (Verified by PD) 3. The applicant has passed an inspection from the St. Joseph County Health Department. 4. The massage establishment as proposed by the applicant would comply with all applicable laws, including but not limited to the City's building, zoning, health, fire and safety regulations. (Fire and Zoning, please verify) 5. A recognizable and legible sign shall be posted at the main entrance identifying the establishment as a massage establishment. (PW — please verify) POLICE: Favorable recommendation FIRE: Favorable COMMUNITY INVESTMENT: Use is allowed within this district. No issues at this time. For all municipal business license questions, contact: City of South Bend • Department of Community Investment 227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 •574.235.5912 • F: 574.235.9021 ReC .7 1 D©A1 $091,05:'_0 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT CAS R MUNICIPAL CODE SECTION - 4-35 I. APPLICATION TYPE Check One: New Renewal e� II. BUSINESS DATA A. Business Name: B. Business Address: S. Lan 11,r 2 r, City: 5�f,, .l �l e �l State: j"V Zip: �/bl,6 /S C. Mailing Address (If different from above): City: State: Zip: D. Business Telephone Number: 57 % E. Business Fax Number: F. E-Mail Address: Jil >.L & L F y--, G. Zoning of Business Location: C& . e h n I 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 !l 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: /0 SS4,:2e -fh 'e J. Include a list of massage therapist employed at this location: (include a separate sheet if necessary) A* For Office Use Only Application Flied FEB 2 2 7023 Public Safety Approval Application Fee PaidFER 2 2 mn License Fee Paid Sent to Dept. FEB 2 2 License Number [r]!SC. A{ 91,6—O Itp o l i CFO ? 3 ja .3_.,f I (c ,./Z0 n j B� _ 2 3 2 l-deal-�-h -# �--5 o[ Not Approved ^ CITY OF SOUTH BEND, INDIANA RlIA RTI rTF PT iRT T!` Wl1RTCC �� Reason 1*aa Elizabeth A. Maradik, President Gary A. Gilot, Member M„rrav T. Mill— MPmhx I' Joseph R. Molnar, Vice President Jordan V. Gathers, Member Aft—t• ThP . M Hrffnx ('1-1, T7 Date: April 25, 2023 For all municipal business license questions, contact: City of South Bend - Department of Community Investment 227 West Jefferson Blvd - Suite 1400 S -South Bend, Indiana 46601 - 574.235.5912 - F: 574.235.9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 III. OWNERSHIP A. Type of ownership (check one): t� f Sole Proprietorship (If sole proprietorship, proceed to 1). Partnership (If partnership, proceed to 2). Corporation (If corporation, proceed to 3). 1. Sole Proprietor Name: + tvu n Residential Address: City: a 5 L e a/-. State: Zip: YLa 2. Partnership (List at least two (2) partners) Name #1: Residential Address: City Name #2: Residential Address: City: 3. Corporation State: Zip: State: Zip: Legal name of corporation: Date and state of incorporation: List officers and directors who own 15% or more of stock: Name #1: Title: Business Address: City: State:_ Residential Address: City:_ State: — Name #2: Title: Business Address: Citv: Residential Address: City: N State: p: Zip: Zip: Zip: a, For all municipal business license questions, contact: City of South Bend • Department of Community Investment 227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 III. OWNERSHIP (Continued) 3. Corporation (Continued) Name #3: Title: Business Address: City: State: Zip: Residential Address: City:_ State: Zip: IV. PERSONAL DATA A. Applicant's Legal Nar B. Residential Address: City: LZ s Ce r.I.', State:_ (rfI Zip: _Y1 51_ C. Residential Telephone Number: 3 % V— a / S� D. Residential Fax Number: E. Cellphone Number: / ' 7 ` — Cj 0�" F.E-Mail Address: ;L G. Position with business: 0 L✓ M -c,r H. Please list all criminal convictions (if any), excluding traffic violations: Nature of Conviction City State Date (Attach additional sheets if necessary) I. Please list all addresses for three (3) years prior to application date: Street Address City State Dates (Attach additional sh J. Date of birth: E K. Gender: L. Social Security Number:- M. Race: 3 For all municipal business license questions, contact: City of South Bend • Department of Community Investment 227 West Jefferson Blvd • Suite 1400 S -South Bend, Indiana 46601 • 574.235.5912 • F: 574.235.9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 IV. PERSONAL DATA (Continued) N. Photographs: I r � � •R rw! C' I to the ante or tnis appncation. Company Address City, State, ZIP r Dates ik1+rel k5i k,- , 3! 3f / /'-a. ,_i4rl�S �j�•�Y�G� � rw'�v .z-f�4 (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 I, 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. (� �Ai�r�� —)mac? . Signature Date 4 0 St. Joseph County Department of Health 'Pr=otM physical and menial health and factiltahng the prevention of dr`sease, injury, and disability for all St Joseph County tes/dents, " 5T. JOSEPH COUNTY "PAO 404? OF p...,,, ...Ira Permit For: Performing Massage Therapy Issued To: LING WANG Expires: 2/28/2024 SR/Permit No: 2301087 The person identified above is authorized to perform Massage Therapy in accordance with St. Joseph County Code 113. Massage Therapy may only be perl`ormed at a facility with a Massage Establishment Permit. This permit must be posted in view of the public Robert Einterz, M.D. St. Joseph County Health Officer SOUTH BEND POLICE DEPARTMENT APPROVAL Michelle Adams From: Kristin Stantz Sent: Thursday, February 23, 2023 2:04 PM To: Michelle Adams Cc: Jarveair Bourn Subject: RE: Business License Apps. 2/23 Michelle, South Bend does not have any disputes with King Asian Massage, Flaming Chariot Tattoo, Jason Haney, Sierra Eagleson, and William Fashbaugh. Sincerely, Kristin Stantz PFC. Strategic Intel Office South Bend Police Department Email:kstantz@southbendin.gov From: Michelle Adams <madams@south bendin.gov> Sent: Thursday, February 23, 2023 9:40 AM To: Kristin Stantz <kstantz@southbendin.gov> Cc: Jarveair Bourn <jbourn@southbendin.gov> Subject: Business License Apps. 2/23 Hi Kristin, Attached are 5 business/occupational license applications for your review and recommendation. MASSAGE ESTABLISHMENT • King Asian massage TATTOO ESTABLISHMENT • Flaming Chariot Tattoo TATTOO ARTIST • Jason Haney • Sierra Eagleson ■ William Fashbaugh Thank You, Mic`ieCCe .Adams City of South Bend Business License Administrator Department of Community Investment 227 W. Jefferson Blvd., Suite 1400 S. South Bend, IN 46601 (574)235-5912 1 ZONING DEPARTMENT APPROVAL Michelle Adams From: Rachel Boyles Sent: Thursday, February 23, 2023 10:06 AM To: Michelle Adams Subject: RE: Business Zoning Verification Good Morning Michelle, The property located at 914 S Ironwood and 3601 E. Jefferson Blvd are zoned NC Neighborhood Center and a Massage Establishment falls under the Personal Care & Services use and is allowed by right in this district. Thank you, RacheCBoyCes Zoning Specialist Department of Community Investment 227 W. Jefferson Blvd., Suite 1400 S. ^ti! South Bend, IN 46601 (574)235-7625 www.southbendin.goy/zon1np- We deliver services that empower everyone to thrive. Excellence I Accountability I Innovation I Inclusion I Empowerment From: Michelle Adams <madams@southbendin.gov> Sent: Thursday, February 23, 2023 10:00 AM To: Rachel Boyles <rboyles@southbendin.gov> Subject: Business Zoning Verification Hi Rachel, Will you please verify that the establishments are allowed to operate as a massage establishment. 4 King Asian Massage — 914 S. Ironwood Dr. (Renewal) • Summer Spa Massage — 3601 E. Jefferson Blvd. (Renewal) Thank You, 13E JWicheCCe .Adams ,� City of South Bend Business License Administrator ram•. Department of Community Investment 227 W. Jefferson Blvd., Suite 1400 S. South Bend, IN 46601 (574)235-5912 1