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Home My WebLink AboutLicense - Massage Establishment Renewal - Therapeutic Indulgence1316 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 23, 2024 Ms. Sara Ros Frazier Therapeutic Indulgence 903 E. Jefferson Blvd. South Bend, IN 46617 therapeuticindulgence(a^,gmail. com RE: Approval — License Application for Massage Establishment Dear Ms. Frazier: At its April 23, 2024 meeting, the Board of Public Works approved your request for the Massage Establishment at 903 E. Jefferson Blvd. 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 MURRAY L. MILLER BRIANA N. MIcou INTEROFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE: 02/16/2024 TO: Brad Rohrscheib, Police Department St. Joseph County Health Department - see attached Derek Erquhart, Fire Department Kari Myers, Zoning Department FROM: Theresa Heffner, Clerk SUBJECT: RENEWAL - MASSAGE ESTABLISHMENT LICENSE RECOMMENDATION BUSINESS NAME: THERAPEUTIC INDULDGENCE ADDRESS: 903 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 Recommendation COMMUNITY INVESTMENT: The use is a permitted primary use in the NC Neighborhood Center district. For all rnunid pal husiness Ilcense questions, oontar_t: City of South Bend • Department of Community Investment 227 Wes[ Jefferson Blvd • Suite 14005 •Soutti Bend. Indiana 46601 •574.235.5912 • F: 574.235.9021 CKS.3 3 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICI PAL CODE SECTION -4-35 I. APPLICATION TYPE Check One: New Renewal t/ If. BUSINESS DATA A. Business Name: `!-lE'�P�i�li1[� �1171,LtLt.7L B. Business Address: e-)02R�rJ D city: �ot.� ��►-��7 C. Mailing Address (If differentfrorn above): City: State: Zip: D. Business Telephone Number:{ Sid ll�e� E. Business Fax Number: F. E-Mail Add ress�}?tJ►ic'�.l�ula[I __. f"-.4-.Ate __a�3M G. Zoning of Business Location. n6 if3OM-',4trt tr> Gf-,N +C='� H. Have you ever had a Massage Establishment license, or similar license, suspended or revoked by any governing municipal' ithin three (3) years prior to the date of thisapplication: YES NO Z. If yes, what was the reason: 2. If yes, what was the business occupation following thesuspension/revocation: I. Describe the nature and scope of the business:_�3 tom:"fit tf'O:.k3+� Ar rl k� i�� t� s� }.-+�.i��c[�✓V �'C�12�.Fc�� _ S�iJ�7 Cf4�� A-, �L .0 _ It'S �_t�•t P��Z_ For Office Use Only Application Filed FEB 1 6 20 Public Safety Approval Application Fee Paid r Ets I b niq License Fee Paid Sent to Dept. r �B 1 (j 2V_1I License Number GA 27 Not Approved CITY OF SOUTH BEND, INDIANA BOARD OF PUBLIC WORKS Reason tIU4 M Elizabeth A. Maradik, President �ts7J�7 Gary A. Gilot, Member 9yg"r 4 Murray L. Miller, Member Joseph R. Molnar, Vice President Briana Micou, Member 6,,; /. Attest: Theresa M. Heffner, Clerk Date: April 23, 2024 For all municipal business Ilcenu quesdars, contact CM/ of South Bentl • Depatlment of Community Investment W Weatleflerow BIM -Suite 1a005 •So M Bend, Indiana 06601 • 570.235.5912 • F: 574.a95.9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 Ill. OWNERSHIP A. Type of ownership eckone): Sole Proprietorship (If sole proprietorship, proceed to 1). Partnership (If partnership, proceed to2). Corporation (If corporation, proceed to 3). 1. Sole Proprietor Name: 5fvzA 12� VVS Zile, Residential Address: VD City: State: \a zip: LAV, 6kav 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: Namell 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 hunnneea license quertlon , mrmot City of South Bend • Department of Community Imrestment 227 Wert Jefferson Blvd • Suite 1400 S •South Bend, Ind lam 46601 •574.235.5912 • F: 9123SM21 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 III. OWNERSHIP (Continued) 3. Corporation (Continued) Name #3: Business Address: Residential Address: City- State: zip IV. PERSONAL DATA A. Applicant's Legal Name: 50idi V_0° VR Z.t¢1L B. Residential Address: OJ`C'k'.4- MRRA.R+J QD City: LSrY.¢VtkC state: \J zip: �A6S241dr C. Residential Telephone Number: Urn. D. Residential Fax Number. rJlor fA E. Cellphone Number: 51-LA 5710 F.E-Mail Address: 44tQARnSF2sF7.:¢2@ G-v-�A�L -(A t'1 G. Position with business: ie%U).Ye2 X2 V%&%%fdne TVLEe Ill 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 prior to application date: Street Address City State Dates Z "Pal-oraz 2A \_kLZV\\A>c \V 0StNLF la" (Attach additional sheets if necessary) For all muniupal business license nuesnons, contactCity of5outh Bend • oepan mein ed Cammuney Investment 227 Wert Jefferson 61W • Suite 1400 S -South Bend, Indiana 461 •5]4.B5.5912 • F: 570.2 S 9 UI LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 IV. PERSONAL DATA(Continued) N. Photoeraohse Company Address City, State, ZIP Dates ! . — ,=v�w7 4 tea' — _ 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 WITHAPPLICATION VII. INCLUDE A UST OF ALL MASSAGE THERAPIST EMPLOYED BY ESTABLISHMENT T4�';T+�Zftp— �30<% V_aun.t Nt� /SPp-t>AN, S,- ¢ kAA Cm�CokJoiEv��or� 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 noway attempted to mislead the City in this application by omitting facts 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 43S. Signature Date