HomeMy WebLinkAboutLicense - Massage Establishment Renewal -King Asian 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
June 24, 2025
Ms. Jing Wang
King Asian Massage
914 S. Ironwood Drive
South Bend, IN 46615
Jingwan _ O�ngmail.com
RE: Approval — License Renewal of Massage Establishment
Dear Ms. Wang
At its June 24, 2025 meeting, the Board of Public Works approved your request for the
renewal of the Massage Establishment at 914 S. Ironwood Drive.
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: 03/03/2025
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: KING ASIAN MASSAGE
ADDRESS: 914 S. IRONWOOD DRIVE
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: Favorable Recommendation
For all municipal business license questions, mntaM City of South Bend • Department of community investment um
227 West Jefferson Blvd • suite 1400 S -South Bend, Indiana 45501 ■574.235.5912 - F: 574.235.9021
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LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
I. APPLICATION TYPE Check One:
II. BUSINESS DATA
New Renewal )�
A. Business Name: King Asian Massage
B. Business Address: 914 S. Ironwood ❑r.
city: South Bend
C. Mailing Address (If different from above):
State: IN
lip: 46615
City: State: Zip:
D. Business Telephone Number. 574-855-4254
E. Business Fax Number:
F. E-Mail Address: jingwang0329@gmail.com
G. Zoning of Business Location: Commerical
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 fallowing thesuspension/revocation:
I. Describe the nature and scope of the business: Massage Therapy
For Office Use Only
Application Filed FEB 2 S 2025 Public Safety Approval
Application Fee Paid FEE $ 225 License Fee Paid
Sent to Dept_� license Number M S615 dAS_Q 13
�y& CITY BOARD FOFO UTH BEND, DIANA
UBLIC WO K
PQl
Not Approved
Reason
Elizabeth A. Maradik, President Joseph R. Molnar, Vice President
_
Gary A. Gilot, Member Briana Micou, Member
Murray L. Miller, Member
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Attest: Hillary Horvath, Acting Clerk
Date: 6/24.17 5
For all municipal businesslicensequestions, contact: City ofsouth Send• ouparo entof Community Investment
227 West Jefferson Blvd • Suite 1400 s •South Bend, Indiana 46601 • 576235.59n • F.524235.9021
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
Ill. OWNERSHIP
A. Type of ownership (check one):
x Sole Proprietorship (If sole proprietorship, proceed to 1).
Partnership (If partnership, proceed to 2).
Corporation (If corporation, proceed to 3).
1, Sole Proprietor
Name:Jina Wang
Residential Address:
City;Osceola state :IN zip:46561
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:
Ti6e:
Business Address:
City; State: Zip:
Residential Address:
City: State: Zip:
2
For all muniuyal buslress license questions, contact: Oty of South Bend • Department of Community Imrestment
227 West Jefferson Blvd • Sude 14005 •South Bend, Indiana 46601 • 574.235.5912 • F' 574.235.9021
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
III. OWNERSHIP (Continued)
3. corporation (Continued)
Name #3:
Title:
Business Address:
City: State: Zip:
Residential Address:
City: State: Zip:
IV. PERSONAL DATA
A. Applicant's Legal N
B. Residential Addres
City Osceola state:IN zip:46661
C. Residential Telephone Number: 574-888-3888
D. Residential Fax Number.
E. Cellphone Number: 574-888-3888
F. E-Mail Address: Jingwang0329Qgmail.com
G. Position with business: Owner
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
For all municipal business license questions, contact: City of Sound Bend • nepartment of Community Investment
222 West Jefferson Blvd • Suite 14005 •South Bend, Indiana 466e1 •5)4.235.59U • F: 574.235.9021
LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT
MUNICIPAL CODE SECTION - 4-35
IV. PERSONAL DATA (Continued)
O. Please list all previous employment for three (3) years prior to the date of this application:
Company Address City, State, ZIP Dates
King Asian Massage 914 s. Ironwood South Bend IN. 46614 7/2022
(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
VIL 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 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.
I�n� uLan�
Signature
2/22/20*
Date
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