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Home My WebLink AboutLicense - Massage Establishment Renewal - Dig Deep Massage Co.1316 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 March 26, 2024 Ms. Heidi L. Kagarise Dig Deep Massage Co. 401 E. Colfax Ave., Suite 180 South Bend, IN 46601 Digdeep574&gmail.com RE: Approval — License Renewal of Massage Establishment Dear Ms. Kagarise: At its March 26, 2024 meeting, the Board of Public Works approved your request for the Massage Establishment at 401 E. Colfax Ave., Suite 180, South Bend, IN 46601. 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 MURRAY L. MILLER BRIANA N. MIcou INTEROFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE: 02/27/2024 TO: Brad Rohrscheib, Police Department St. Joseph County Health Department - see attached Gerald Ellis, Fire Department Kari Myers, Zoning Department FROM: Theresa Heffner, Clerk SUBJECT: RENEWAL - MASSAGE ESTABLISHMENT LICENSE RECOMMENDATION BUSINESS NAME: DIG DEEP MASSAGE CO. ADDRESS: 401 E COLFAX AVE STE 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: Insert Recommendation COMMUNITY INVESTMENT: The use is a permitted primary use in the DT Downtown district. For all munid pal business license questions, contact: City of South Bend -Department of CommunityInvestment 227 West Jefferson Blvd •Sulte 1400 S -South Bend, Indiana 46601 - 574.235.5912 - r: 574.235.9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT C'-t: S 10, MUNICIPAL CODE SECTION -4-35 I. APPLICATION TYPE Check One: New Renewal k/1 II, BUSINESS DATA U -tom 1 A. Business Name: D 1�I PDF'l9._0.aSMe l , R. Business Address: 9bi '� • CO )C VQ_J ��7 City: SO W+(A- E State: i V4 zip: 4 (e_ lR[7 C. Mailing Address (If different from above): City: State: Zip: D. Business Telephone Number: J-i'� 2200— E. Business Fax Number: F. E-Mail Address: G. Zoning of Business Location: A . 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 thesuspension/revocatiom I. Describe the nature and scope of the business: T nyl akgApit -�C- For Office Use Only Application Filed FEB 2 6 2024 Public Safety Approval Application Fee Pair,[ F�_ 6_2024 License Fee Paid Sent to Dept. License Number M S E_;1Q %4 -0Q7 Aj.- A40106S Not Approved Reason CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS -aa, a Elizabeth A. Maradik, President Gary A. Gilot, Member 4 7_1&__1 Murray L. Miller, Member �P1 Joseph R. Molnar, Vice President Breana N. Micou, Member Attest: Laura D. Hensley, Acting Clerk Date: March 26, 2024 For all municipal business license quest'ons, contact: City of South Bend - Department of Community Investment 227 West Jefferson Bled • Suite 14005 -South Bend, Indiana 46601 • 574.235.5912 • F: 574,235,9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 JII.OWNERSHIP A. Type of ownership (check one): Sole Proprietorship (If sole proprietorship, proceed to 1). Partnership (If partnership, proceed to 2). Corporation (If corporation, proceed to3). 1. Sole Proprietor Name: I Residenti; City: 4 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 IS% or more of stock: Name #1: Title: Business Address: City: State: Zip; Residential Address: City: State: zip: Name #2: Tit le: Business Address: Crty. State: Zip. - Residential Address: City: State: Zip: 2 For all municipal business limner question:, mdad: clµ 05outh Bend . Crepanmentof Community Imeztment 227Wert Jefferson Blvd • Suite 14005 -South Bend, Indiana 46601 • 574.235.5912 • F: 524.235.5021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION -4-35 III. OWNERSHIP (Continued) 3. Corporation (Continued) Business Address: Residential Address: IV. PERSONAL DATA A. Applicant's Legal Nam B. Residential Address: City: SLBb1'6L$G State: I zip: N (e(¢l7 C. Residential Telephone Number: D. Residential Fax Number. E. Celephone Number- F. E-Mail Address;- G. Position with business: aW IO'nfesai AP- H. Please list all criminal convictions (if any), excluding trafficviolations: Nature of Conviction City State Date (Attach additional sheets if necessary) I. Please Ilst all addresses for three (3) years prior to application date: Street Address City State Dates f.L[XY'PA& k if (Attach additional sheets if necessary) For all munidpal businesslicensequestions,midd CMyof south Bend, Department of Cnmmunny Iw2IIment 222 West Jefferson Blvd • Suite 1� 5 -South Bend, Indiana 4601 • 574.235.5912 • F: 57C23IM21 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION -4-35 IV. PERSONAL DATA (Continued) N A otos, tv' O. Please list all previous employment for three (3) years prior to the date of this application: Company Address City, State, ZIP Dates �,��- l t L t • . (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 WITHAPPUCATION VIL INCLUDE A LIST OF ALL MASSAGE THERAPIST EMPLOYED BY ESTABLISHMENT Vill. 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 omittingfacts known tome. 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 certify that I will not allow massage therapy to be performed at this establishment by any person who does not possess a current massage therapist license. 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 Date Fr,S,3 5t. Joseph C:aunty Department ofTo orc�mote healthand wellness wit" compassiont&ougn pa-tnei5;�ips, educatiGf•1�.pmter-tion, and advo reside ir: and visit St. JosephCounty.DC;-0,R7HLNT OF HFA. TH r,...,i v.-moo.n. "I Permit For: Operation of a Massage Establishment tssucd To. DIG DEEP MASSAGE CC Owner. i1EIDI KAGARISE Expires: �/2812025 SR/Permit No: 2401065 The St. Joseph County Health authorizes Massage Therapy to be performed armrdance with St. Joseph County Code 113. Any person performing a mas Permt. This permit must be posted in view of th i- Diana Puruslhotham, M.D. St. 3oseph County Health Office L--