The URL can be used to link to this page

Home My WebLink AboutLicense - Massage Establishment Renewal - Summer Spa 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 March 26, 2024 Ms. Mei Li Sun / Mr. Wendell Sheldon Summer Spa Massage 3601 E. Jefferson Blvd. South Bend, IN 46615 1726065950&QQ.com RE: Approval — License Renewal of Massage Establishment Dear Ms. Sun & Mr. Sheldon: At its March 26, 2024 meeting, the Board of Public Works approved your request for the Massage Establishment at 3601 E. Jefferson Blvd., South Bend, IN 46615. 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: 02/19/2024 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: SUMMER SPA MASSAGE ADDRESS: 3601 E. JEFFERSON BLVD. 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: The use is a permitted primary use in the NC Neighborhood Center district. For all munidpaI 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 I. APPLICATION TYPE Check One II. BUSINESS DATA New Renewal X A. Business Name: SUMMER SPA MASSAGE B. Business Address: 3601 E. JEFFERSON bLVD. City. SOUTH BEND State: IN ZPp, 46615 C. Mailing Address (If different from above): city: D. Business Telephone Number: 574-383-5035 E. Business Fax Number: F. E-Mail Address: 1726065950@QQ.COM Zip: G. Zoning of Business Location: NEIGHBORHOOD CENTER 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: PROVIDE THERAPEUTIC MASSAGE For Office Use Only Application Filed FEB 1 6 2024 Public Safety Approval Application Fee Paid License Fee Paid FEB 4 Sent to Dept. F E8 1 9 ZUZ4 License Number ,��`7�.._' � 5�'Lr CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Not Approved yy /Z V' Reason Elizabeth A. Maradik, President Joseph R. Molnar, Vice President Gary A. Gilot, Member Breana N. Micou, Member Murray L. Miller, Member Attest: Laura D. Hensley, Acting Clerk Date: March 26, 2024 For all municcal business license questions, content: City ofSouN Bone! • Department of rnmmunhy Irn¢[ment 227W6tlethrson BNtl • Sune 14MS •Soutr Bend, Indiana 46601 • 57C235.5912 • F.514215.9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 III.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 to 3). 1. Sole Proprietor Name: MEI LI SUN WENDELL SHELDON Residential Address: 14535 DAY RD. Cam. MISHAWAKA State: IN Zip: 46545 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 stock: Name#1: Title: Business Address: City: State: Zip: Residential Address: City: State: Zip: Name #2: Title: Business Address: City: State: Zip: Residential Address: City: State: Zip: 2 For all municipal business Ranee quenVons, mmact: City of South Bend • Department of Cammunily lee tment n7 WestleRerson BIW • Suite 1400S •South Bend, Indiana 46601, 574.235.5912 • F:5762359021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 III. OWNERSHIP (Continued) 3. Corporation (Continued) Name #3: Business Address: Residential Address: IV. PERSONAL DATA A. Applicant's Legal Name: MEI LI SUN / WENDELL SHELDON B. Residential Address: 14535 DAY RD. rin,. MISHAWAKA ctoro.IN Tin 46545 C. Residential Telephone Number: 302-428-1202 D. Residential Fax Number. E. Cellphone Number: F. E-Mail Address: 1726065950@QQ.COM G. Position with business: OWNER H. Please list all criminal convictions (if any), excluding trafRcviolations: Nature of Conviction City State Date (Attach additional sheets if necessary) I. Please list all addresses forthree (3) years prior to application date: Street Address City State Dates SAME 3 For all municipal business license Questions, contact: City of South Bend • Department of community Investment 227 We4lefrerson BIW • 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) a<rnnrt por � 9nths lk O. Please list all previous employment for three (3)y�rior to t� of this application: Company Address City, State, ZIP Dates (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. INCLUDE A LIST OF ALL MASSAGE THERAPIST EMPLOYED BY ESTABLISHMENT Vill. AFFIRMATION I, hereby, certify and affirm that all ofthe 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 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. 02/16/2024 Signature Date 4 y., St. Joseph County Department of Health J "To promote health and wellness with Compassion and integrity 11 through partnerships, ?duration, protection, and advocacy for all who reside in and visit St. Joseph County:" ST, JOSLPH COUNTY Permit For: Operation of a Massage Establishment Issued To: SIVMER SPA 1 Owner: MEI G S12N Expires' 2/2e/2025 i SR/Permit No: 2g00995 The St. Joseph County Health authorizes Massage Therapy to be performed at the facility identified above in accordance with St. Joseph County Code 113. Any person performing a massage must have a Massage Therapist I Permit. I � This permit must be posted in view of the public Diana Purushotham, M.D. St. Joseph County Health Officer