HomeMy WebLinkAboutNew Massage Establishment - Massage By Jenn1316 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
June 24, 2025
Ms. Jennifer Rasey
Massage By Jenn
814 E. LaSalle Ave.
South Bend, IN 46617
Massa _ eg_byj enn 19kgmail.com
RE: Approval — License Application for New Massage Establishment
Dear Ms. Rasey:
At its June 24, 2025 meeting, the Board of Public Works approved your request for the
New Massage Establishment at 814 E. LaSalle Ave.
If you have any further questions, please call this office at (574) 235-9251.
Sincerely,
/s/HiIlary Horvath
Hillary Horvath, Acting Clerk
Enclosures
HH
ELIZABETH A. MARADIK JOSEPH R. MOLNAR GARY A. GILOT MURRAY L. MILLER BREANA N. MIcou
INTEROFFICE MEMORANDUM
BOARD OF PUBLIC WORKS
DATE: 01 /09/2025
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: MASSAGE ESTABLISHMENT LICENSE
RECOMMENDATION
BUSINESS NAME: MASSAGE BY JENN
ADDRESS: 814 EAST LASALLE AVENUE
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
ZONING DEPARTMENT: 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 @ bepartment of Community Investment
227 West Jefferson Blvd • 5ulte 1400 5.5outh Bend, Indiana 46601 • 574.235.5912 • F: 574.235,9021
-Ree.I01ta84'��J°
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
I. APPLICATION TYPE Check One: New Renewal
II. BUSINESS DATA
A. Business Name:
B. Business Address:
City:l State: zip:
C. Mailing Address (If different from above). �-,li />-.
City: State: Zip.
D. Business Telephone Number: r.
E. Business Fax Number: N /W
F. E-Mail Address: r- In-_-)_YIL V " 11(/T )I ) I `-1 (1) C 111 Y11 l -
G. Zoning of Business Location: i L_)GLutr9]I L)rj
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 V
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: _ r�
r
For Office Use Only
Application Filed JAN 0 8 2025- Public Safety Approval
Application Fee Paid AKI U 8 NE License Fee Paid
Sent to Dept. TINE 8 20 .rBOARD
Number MSEA 5 —Oct
Fire Approval SBPD Approval CITY D SOUTH BEND, INDIANA
D OF PUBLIC WORKS
-*1�
Not Approved Health Permit
Elizabeth A. Maradik, President Joseph R. Molnar, Vice Presidcnt
Reason a� 4
Gary A. Gilot, Member
%YL✓✓y � %IZc�G
Briana Micou, Member
1 Murray L. Miller, Member Attest: Hillary Horvath, Acting Clerk
Date: 06/24/2025
For all municipal business license questions, contact: City of Soutb Bend • Department of Community Investment
227 West Jefferson Blvd • Suite 1400 S •SouM Bend, Indiana 46601 • 94.235.5912 • F: S94.335.9021
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
III. OWNERSHIP
A. Type of owpership (check one):
0/ Sole Proprietorship (If sole proprietorship, proceed to 1).
Partnership (If partnership, proceed to 2).
Corporation (If corporation, proceed to 3).
1. Sole Proprietorl,,�,� ��
c,n
Name: ( T 1 ��y �nn 11 _CA 4
Resid ntial Add\r—ess' )) \ � m I
City: ��' l State'
+ '
Zip' 4&JO
2. Partnership (List at least two (2) partners)
Name#1:
Residential Address:.
City: State:
Zip:
Na me #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 f12:
Title:
Business Address:
City: State:
Zip:
Residential Address:
City: State:
Zip:
2
For all municipal business license questions, contact City of South Bend • Ce parlment a Community Investment
222 West Jefferson Blvd • Suite 1400 5 -South Bend, Indiana 46501. 524.2355912 • F: 574.235.9021
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
Ill. OWNERSHIP (Continued)
3. Corporation (Continued)
Name #3:
Title:
Business Address:
City: state_ Zips
Residential Address:
City; State: Zip:
IV. PERSONAL DATA
A. Applicant's Legal Nan
B. Residential Address
City: Sta ": ��� Zip:
C. Residential Telephone NumberA l /� 1 I�
D. Residential Fax Numb r: 11
E. Cellphone Number
F. E-Mail Address:
G. Position with business:
H. Please list all criminal convictions (if any), excluding traffcviolations:
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
r
(Attach additional sh is if.ne essary)
1.
L
3
For all municipal business license questions, contact CM of South Send • Department of community Investment
227 West Jefferson Blvd • Suite 1400 s •South Bend, Indiana 46601 •574235.5912 • F: 574.235.9031
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION — 4-35
IV. PERSONAL DATA (Continued)
0. Please list all previous employment for three (3) years prior to the date of this application:
_gig,of
1i>2_ DON
(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. AFFIRMATION
(,hereby, certify and affirm that all of the! nformation 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 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.
U u SS%nature `j Date