HomeMy WebLinkAboutMassage Establishment Renewal - Soul Fire Yoga LLC1316 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 13, 2025
Ms. Alyssa Rios
Soul Fire Yoga LLC
2314 E. Mishawaka Ave.
South Bend, IN 46615
soulfireyogasb(i ,gmail.com
RE: Approval — License Renewal of Massage Establishment
Dear Ms. Rios
At its May 13, 2025 meeting, the Board of Public Works approved your request for the
renewal of the Massage Establishment at 2314 E. Mishawaka Ave.
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: 02/26/2025
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: SOUL FIRE YOGA
ADDRESS: 2314 E. MISHAWAKA AVE.
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 Ilee nse questions, contact: City of south Bend • Department of Community Investment
Z27 West Jefferson Blvd • Suite 1400 5 ■5auth Bend, Ind lane 46601 • 574.235.591-2 ■ F: 574.235.9021
RAC Aot 7bq op
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT I�K 11ST
MUNICIPAL CODE SECTION - 4-35
I. APPLICATION TYPE Check One: New Renewal
II. BUSINESS DATA
A. Business Name: �Z�k V'yrG �1acict LLL
B. Business Address: 2A14 4e. hNis',"Woxa J'+vG
city: se State: 10 Zip: 4101D
C. Mailing Address (If different from above):
City:
State:
D. Business Telephone Number: 5114- SI 3 —2 24 4
E. Business Fax Number:
Zip:
F. E-Mail Address: �V�ky- a ct sb Q ci , to
G. zoning of Business Location:
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 thisapplication:
YES NO •�,`[
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:
4 a S is f �. Vmp Classes . ho A j s e_
For Office Use Only
Application Filed FEB 2 5 2025 Public Safety Approval
Application Fee Paid FEB 2 5 2D? License Fee Paid FEB
�Sent tof Dept._-y �-7--F E 25 799 license Number
•' P����7 ~ I7 CITY OF SOUTH BEND, INDIANA
BOARD OF PUBLIC WORKS
Not Approved i*t�a
Reason
Elizabeth A. Maradik, President Joseph R. Molnar, Vice President
Gary A. Gilot, Member
Breeana Miicou, Member
y- t1.1. / /'.`.
Murray L. Miller, Member
Attest: Theresa M. Heffner, Clerk
Date: May 13, 2025
For all municipal business license questions, contaM Cityd Sooth Bend • Department of Community Investment
227WeA Jefferson BIW • Suite 1400 S •South Bend, Indiana 46601 • 574.235.5912 • F: 524.235.9021
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
III. OWNERSHIP
A. Type of ownership (check one):
lC Sole Proprietorship (If sole proprietorship, proceed to 1).
Partnership (If partnership, proceed to 2).
Corporation (If corporation, proceed to 3).
1. Sole Proprietor
Name: SSA OS
Residential Address
City: t�kwl%awca.Ka State: [NJ
Zip: y454S'
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 license questions, contact City of South Bend • Department of Community Investment
227 Wes:Jefferson Blvd • Suite 14005 'South Bend, Indiana 46603 • 574.235.5912 • F: 574.235.91321
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
III. OWNERSHIP (Continued)
3. Corporation (Continued)
Name #3:
Business Address:
City: .State: Zip:
Residential Address:
IV. PERSONAL DATA
A. Applicant's Legal Name: o S
B. Residential Address:
City: M.a, Aw aks State: IN Zip: N(o S4S
C. Residential Telephone Number:
D. Residential Fax Number:
E. Cellphone Number:61LI - 850 -31Qci
F. E-Mail Address: mv%j{n ,c4sapigl'6 AP3jAI.Feaara
G. Position with business: 0t a.ar ( CEO
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 applicationdate:
Street Address City State Dates
c103 "1 X\y Or ST; IN 67/2.0t g - lo/�
For all municipal business license questions, contact Cily of south Bend • Department of Community investment
227We4l rson Blvd • Suite 14W S 150uth Bend, Indiana 46601 '574'235.5912 • F:52a.135.9021
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
IV. PERSONAL DATA (Continued)
or
no
ion.
O. Please list all previous employment for three (3) years prior to the date of this application:
Company Address City, State, ZIP Dates
p�
Prphoyice .\'\h 7bk Palrrs.av /pnm,}Ed fa.ksLad4 cA 94ok) rn�ygY_� n�.
Vitl.inwn idmi1y DwM 39IS Pa.kil Am 59t IA1 10"I of 12022-2961ilyxy
(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
5 ptniq VAoDf2
U
VII. AFFIRMATION �MA cvA
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 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.
_ II3glaoas
Signature Date
§§
{}
of
0_
k
mE
\«\
c
{)
k))
�\
.aG
!
| E
!\
)}
!
{;
!
3;
}k!
Do}
'
k
x
;m£