HomeMy WebLinkAboutLicense - Massage Estasblishment Renewal - Southside Massage Retreat1316 COUNTY -CITY BUILDING
227 W. JEFFERSON BOULEVARD
SOUTH BEND, INDIANA 46601-1830
PHONE 574/235-9251
FAx 574/235-9171
CITY OF SOUTH BEND TAMES MUELLER, MAYOR
BOARD OF PUBLIC WORKS
May 23, 2023
Ms. Sara Cozort
Southside Massage Retreat
401 E. Colfax Ave., Suite 180
South Bend, IN 46601
smretreat(iDhotmail. corn
RE: Approval — License Renewal of Massage Establishment
Dear Ms. Cozort:
At its May 23, 2023 meeting, the Board of Public Works approved your request for the
renewal of your Massage Establishment at 401 E. Colfax Ave., Suite 180.
If you have any further questions, please call this office at (574) 235-9251.
Sincerely,
/s/ 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
Gerald Ellis, Fire Department
Angela Smith, Zoning Department
FROM: Theresa Heffner, Clerk
SUBJECT: RENEWAL - MASSAGE ESTABLISHMENT LICENSE
RECOMMENDATION
BUSINESS NAME: SOUTHSIDE MASSAGE RETREAT
ADDRESS: 401 E. COLFAX AVE SUITE 180
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 14005 -South Bend, Indiana 46601 - 574,235.5912 - F; 574.235.9402J.
aK` 0a'-5
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT Rtv-- L�
MUNICIPAL CODE SECTION - 4-35�"
I. APPLICATION TYPE Check One
II. BUSINESS DATA
A. Business Name:
B. Business Address:
New Renewal
City: ht A
C. Mailing Address (If different from above):
City:
D. Business Telephone Number:
.State: zip,
te: Zip:
F. Business Fax Humber:
F. E-Mall Address:.[`i1��G Q
G. Zoning of Business Location:
H. Have you ever had a Massage Establishment license, or similar license, suspended or revoked
by any governing munieipa within three (3) years prior to the date of thisapplication:
YES NO
1. If yes, what was the reason:
2. If yes, what was the business oc ation following the suspension/revocation;
I. Describe the nature and scope of the business: -1Lw]1 >
Far Office Use Only
Application Filed �EB 2 S nn Public Safety Approval
Application Fee Paid FEB z 6 2023 License Fee Paid
Sent tc Dept._ FEB G 8 2023 License Number.
Po I t C' e- RACL 7Dni I15
Not Approved_ CITY OF SOUTH BEND, INDIANA
Reason BOARD OF PUBLIC WORKS
A. Maradik, President
Gary A. Gilot, Member
%YLwy K
Joseph
✓✓R. Molnar, Vice President
U P5
Jordan V. Gathers, Member
rea
L. Miller, Member
Attest: Theresa M. Heffner, Clerk
Date: May 23, 2023
For all municipal business license questions, contact: City of South Bend • Department of Community Investment
222 Wert Jefferson Blvd • Suite 14005 -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 eck one):
Sole Proprietorship (If sole proprietorship, proceed to 1).
Partnership (If partnership, proceed to2).
Corporation (If corporation, proceed to 3).
1. Sole Proprietor (�
Name::'qQ�
Residential Address: �rmn`1
C. CZQA\l'(-tom State:Zlp:�
2. Partnership (List at least two (2) partners)
Name #1:
Residential Address:
City: State: Zip:
Name #2:
Residential Address:
City: State: Zip:
3. Corporation
Legal name of corporation:
Date and state of incorporation
List officers and directors who own 15%or more of st
Name#1:
Title:
Business Address:
City: State: Zip:
Residential Address:
City: State: Zip:
Name #2:
Title:
Business Addr s:
City: State: Zip:
11esit:107 Address:
City: State: Zip:
2
For all municipal business license questions, contact: City of South Bend • Department of Common" Investment
222 Wert Jefferson Blvd • Suite 14005 •South Bend, Indiana 46601 • 524.235.5912 • F: 574.235.9021
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
III. OWNERSHIP (Continued)
3. Corporation (Continued)
IV. PERSONAL DATA
A -Applicant's Legal Name:
B. Residential Address:G
C. Residential Telephone Number:
D. Residential Fax Number: ^
E. Cellphone Number: 1
F.E-Mail Address:
G. Position with business: H. Please list all criminal convictions (if any), excluding trafficviolations:
Nature of Conviction City State Date
(Attach additional sheets if necessary)
I. Please list all addresses for three (3) years priorto application date:
Street Address city State Dates
.
J. Date of b,
L. Social
M. Race:
For all municipal business 0cense questions, contact: CRY of Soudi Bend • 0epartmert cf Community Investment
227 West Jefferson BIW o Suite 14W S o5outh Bend, Indiana 46601, 574.235.5912 o e 574.235.9021
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
IV. PERSONAL DATA (Continued)
N. Photographs:
Idua�. Irt p
nths
iku'u. I>lease list all previous employment for three (3) years prior to the date of this application:
Company Addess CWS. CQRy,State, ZlP Dates Qoomql
(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.
Sign at a Date
4
Michelle Adams
ZONING DEPARTMENT APPROVAL
From:
Sent:
To:
Subject:
Good Afternoon Michelle,
Rachel Boyles
Wednesday, March 1, 2023 4:15 PM
Michelle Adams
RE: Zoning Verification for Massage Establishments
The properties listed below have the correct Zoning associated with them. A Massage Establishment falls under the
Personal Care & Services use and is allowed by right in NC Neighborhood Center, DT Downtown and C Commercial
Zoning Districts.
Thank you,
RacFieCBoyCes
Zoning Specialist
! Department of Community Investment
t 1 227 W. Jefferson Blvd., Suite 1400 S.
South Bend, IN 46601
(574)235-7625
www. sa ut h b en d i n.govizo n i ng
We deliver services that empower everyone to thrive.
Excellence I Accountability I Innovation I Inclusion I Empowerment
From: Michelle Adams <madams@southbendin.gov>
Sent: Wednesday, March 1, 2023 2:03 PM
To: Rachel Boyles <rboyles@southbendin.gov>
Subject: Zoning Verification for Massage Establishments
Hi Rachel,
Will you please verify that the following are allowed to operate as massage establishments (applications are attached).
• Southside Massage Retreat — 401 E. Colfax Ave. — Zoned Downtown
• New You Oasis — 910 E. Ireland Rd. — Zoned Commercial
• Rachael T Massage — 616 E. Colfax Ave. — Zoned Neighborhood Center
• Therapeutic Indulgence —903 E. Jefferson Blvd. — Zoned Neighborhood Center
• Massage by Suzanne — 914 Lincoln Way W. — Zoned Neighborhood Center
Thank You,
-WicFieCCe .Adams
City of South Bend
Business License Administrator
Department of Community Investment
■ t 227 W. Jefferson Blvd., Suite 1400 S.
South Bend, IN 46601
(574)235-5912
1
SOUTH BEND POLIC DEPARTMENT APPROVAL
Michelle Adams
From:
Kristin Stantz
Sent:
Thursday, March 2, 2023 8:55 AM
To:
Michelle Adams
Cc:
Jarveair Bourn
Subject:
RE: Business License Apps. 3/1/23
Michelle,
The South Bend Police Department has no disputes with the below license applicants.
MASSAGE ESTABLISHMENTS
1.
Southside Massage Retreat
2.
New You Oasis
3.
Rachael T Massage & Essential Oils
4.
Therapeutic Indulgence
5.
Massage by Suzanne
MASSAGE THERAPIST
6. Dena Woods
7. Laura Mattingly
8. Rachael Thompson - owner of Rachael T Massage
9. Sara Cozort — owner of Southside Massage Retreat
10. Sara Frazier — owner of Therapeutic Indulgence
11. Shannon Anderson
12. Suzanne Thomas — owner of Massage by Suzanne
TATTOO ARTIST
13. Alyson Kaluzny
ALARM AGENTS
14. Advanced Security
15. Johnson Controls Security Solutions
Sincerely,
Kristin Stantz
PFC. Strategic Intel Office
South Bend Police Department
Email:kstantz@southbendin.gov
From: Michelle Adams <madams@southbendin.gov>
Sent: Wednesday, March 1, 2023 1:47 PM
To: Kristin Stantz <kstantz@southbendin.gov>
Cc: Jarveair Bourn <jbourn@southbendin.gov>
Subject: Business License Apps. 3/1/23
Hi Kristin,
Attached are 15 business/occupational renewal license applications for your review and recommendations.
MASSAGE ESTABLISHMENTS
1.
Southside Massage Retreat
2.
New You Oasis
3.
Rachael T Massage & Essential Oils
4.
Therapeutic Indulgence
5.
Massage by Suzanne
MASSAGE THERAPIST
6. Dena Woods
7. Laura Mattingly
8. Rachael Thompson - owner of Rachael T Massage
9. Sara Cozort — owner of Southside Massage Retreat
10. Sara Frazier — owner of Therapeutic Indulgence
11. Shannon Anderson
12. Suzanne Thomas —owner of Massage by Suzanne
TATTOO ARTIST
13. Alyson Kaluzny
ALARM AGENTS
14. Advanced Security
15. Johnson Controls Security Solutions
Thank You,
-Vic`i,etfe .Adams
City of South Bend
Business License Administrator
`� y4 Department of Community Investment
227 W. Jefferson Blvd., Suite 1400 S.
South Bend, IN 46601
(574)235-5912
2