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Home My WebLink AboutMassage Establishment Renewal - Summer Spa Massage1316 COUNTY -CITY BUILDING 227 W. JEFFERSON BOULEVARD SOUTH BEND, INDIANA 46601-1830 Ms. Meili Sun Summer Spa Massage 3601 E. Jefferson Blvd. South Bend, IN 46615 1726065950(&00.com PHONE 574/235-9251 FAx 574/235-9171 CITY OF SOUTH BEND JAMES MUELLER, MAYOR BOARD OF PUBLIC WORKS March 25, 2025 RE: Approval — License Renewal of Massage Establishment Dear Ms. Sun At its March 25, 2025 meeting, the Board of Public Works approved your request for the renewal of the Massage Establishment at 3601 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/hh ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT MURRAY L. MILLER BREANA N. MIcou INTEROFFICE MEMORANDUM BOARD OF PUBLIC WORKS DATE: 02/14/2025 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: 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 Recommendation (passed fire inspection) COMMUNITY INVESTMENT: A massage establishment is a permitted primary use in the NC Neighborhood Center district. For all municipal business license questions, contact: City of South Bend -Department of Community Investment CAP—D 227 West Jefferson Blvd - Suite 1400 5.5outh Bend, Indiana 466019 574.235.5912 • F:574.235.13021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 I. APPLICATION TYPE Check One II. BUSINESS DATA New Renewal A. Business !Name: -L I !;Ph Inas(Zge_ KA B. Business Address: 1 r-- .I� f-r�bh 3,I lfrf City: State: i r, _zip: kh I C. Mailing Address (If different from above): City: State: Zip: D. Business Telephone Number: 0: E. Business Fax Number: F. E-Mail Address: r< J, COig G. Zoning of Business Location: W-AW&W. ZIUME 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 _ 4-L 1. If yes, what was the reason: 2. If yes, what was the business occupation following the suspension/revocation: I. Describe the natu re and scope of the business: I U Pr_nfi p e. _j�— r- j�cz�f For Office Use Only Application Filed FEB 1 0 2025 Public Safety Approval Application Fee PaicFEB 1 0 2M License Fee Paid � Eb � � � �1 Sent to Dept. F ER I A 7 2 License Number a 26- 0(—)q J ea f � 1 ) OU LA CITY OF SOUTH BEND, INDIANA 11 BOARD OF PUBLIC WORKS Not Approved 2 yyl Reason 9 Elizabeth A. Maradik, President Joseph R. Molnar, Vice President Gary A. Gilot, Member Breana Micou, Member f" Murray L. Miller, Member Attest: Theresa M. Heffner, Clerk Date: March 25, 2025 For all municipal business license questions, contact: CRy of scum Bend • department of communWr Imestmem 222 WesUefferson Blud • Suite 14005 •Sound Bend, Indiana 46601 • 94.285.591E • F: 574.BS,9021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 Ill. 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 --hill J St2.n/UJendell CAelaDn Residential Address: ILFCIS 11GA)pG/i. City: AA!&& Q(LJCLko State: Iltf zip:t�cV�.r 2. Partnership (List at least two (2) partners) Name #1: Residential Address: City: State; Zip: Name #2: Residential Address: 3. Corporation Legal name ofcorporation: Date and state of incorporation: List officers and directors who own 15%or more of stock: Residential Address: Name For all municipal business license questions, contact; City of South Bend • Department of Cammunky Invennent 222 Wert Jefferson BI W • Suite 1400S •South Bend, Indiana 16601 • 574235.5912 • F:52A21SM21 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 III. OWNERSHIP (Continued) 3. Corporation (Continued) Name H3: We: Business Address: City: State: Zip: Residential Address: City: State: Zip: IV. PERSONAL DATA A. Applicant's Legal Name: MPa LIB SW 110814011 AP B. Residential Address: 1fp l.C' Jay k0a, city; AA, ( ) ai,/" State: l u Zip: kE-wr C. Residential Telephone Number: D. Residential Fax Number. E. Cellphone Number. 1 � p� F.E-Mail Address: 12.40 GS VZO Oa Lim` CIDM G. Position with business: DI.Ih1 P1" H. Please list all criminal Convictions (id any), excluding traff cviolations: 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 14 L 3 I IxtV �z�r..i M k ai1' 4 flh -,w $-present For all munld pal business limme questions, contain City of spurn Be • Department of Community Investment 227 West Jefferson Blvd • Suite 1400 S -South Bend, IMiana 46601 •574.2355912 • F. 574.235A021 LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT MUNICIPAL CODE SECTION - 4-35 IV. PERSONAL DATA (Continued) N. Photographs: p..� n, n_....._' _`_ _ .I n„tu yLnn within A mnntha nftF^ a.... ,.r.r.4 ......B.�b..� t ilm, j 6 m1 / a t {; •. y (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. INCLUDE A LIST OF SERVICES AVAILABLE AND THE COST OF SUCH SERVICES IX. 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 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 4-35. 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