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For all municipal business Ranee quenVons, mmact: City of South Bend • Department of Cammunily lee tment <br />n7 WestleRerson BIW • Suite 1400S •South Bend, Indiana 46601, 574.235.5912 • F:5762359021 <br />LICENSE APPLICATION FOR - MASSAGE ESTABLISHMENT <br />MUNICIPAL CODE SECTION - 4-35 <br />III. OWNERSHIP (Continued) <br />3. Corporation (Continued) <br />Name #3: <br />Business Address: <br />Residential Address: <br />IV. PERSONAL DATA <br />A. Applicant's Legal Name: MEI LI SUN / WENDELL SHELDON <br />B. Residential Address: 14535 DAY RD. <br />rin,. MISHAWAKA ctoro.IN Tin 46545 <br />C. Residential Telephone Number: 302-428-1202 <br />D. Residential Fax Number. <br />E. Cellphone Number: <br />F. E-Mail Address: 1726065950@QQ.COM <br />G. Position with business: OWNER <br />H. Please list all criminal convictions (if any), excluding trafRcviolations: <br />Nature of Conviction City State Date <br />(Attach additional sheets if necessary) <br />I. Please list all addresses forthree (3) years prior to application date: <br />Street Address City State Dates <br />SAME <br />3 <br />