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HomeMy WebLinkAboutReport 1CITY OF RENTO: DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT MEMORANDUM Date: February 11, 2014 To: City Clerk's Office From: Lisa M. Mcelrea Subject: Land Use File Closeout Please complete the following information to facilitate project closeout and indexing by the City Clerk's Office Project Name: Siddiq Mumin Enterprises: Sports Retail Vendor LUA (file) Number: LUA-14-000001, TP Cross-References: AKA's: Project Manager: Kris Sorensen Acceptance Date: January 2, 2014 Applicant: Siddiq Mumin Owner: Shell Gas Contact: Siddiq Mumin PID Number: 0723059007 ERC Determination: Date: Anneal Period Ends: Administrative Decision: Approved with Conditions Date: January 2, 2014 Anneal Period Ends: Januarv 16. 2014 Public Hearing Date: Date Appealed to HEX: By Whom: HEX Decision: Date: Anneal Period Ends: Date Appealed to Council: By Whom: Council Decision: Date: Mylar Recording Number: Project Description: Temporary retail vendor selling sports goods through end of February 2014 Location: 300 Rainier Ave S. Comments: .. ERC Determination Types: DNS -Determination of Non-S1gnif1cance; DNS-M -Determ1nat1on of Non-Significance-Mitigated; DS -Determination of Significance. DEPARTMENT OF COi\ JNITY • l Cityof . fl:~ -------'·~ ~ r·1 rr r I ~:}ff r ···~ . r 1 .. l -,,.,,, -""" ---..,, :::J ,_, -,,, . AND ECONOMIC DEVELOPMENT PLANNING DIVISION TIER 1 -TEMPORARY USE PERMIT DATE OF PERMIT ISSUANCE: LAND USE ACTION FILE NO.: PROJECT NAME: PROJECT MANAGER: OWNER: APPLICANT: CONTACT {if other than Owner): PROJECT LOCATION: DATE OF EXPIRATION: January 2, 2014 LUA14-000001, TP SIDDIQ MUMIN ENTERPRISES: SPORTS RETAIL VENDOR Temporary Use Permit KRIS SORENSEN, Associate Planner SANDY RANA, MANAGER RENTON SHELL GAS STATION 300 RAINIER AVES RENTON, WA 98055 SIDDIQ MUMIN ENTERPRISES-SIDDIG MUMIN, OWNER 3175 S HOOVER ST #375 LOS ANGELES, CA 90007 SIDDIQ MUMIN ENTERPRISES-SIDDIG MUMIN, #(310) 422-7791 300 RAINIER AVES, RENTON, WA 98055 February 28, 2014 PROJECT DESCRIPTION: The applicant proposes to locate a temporary retail vending tent at a property where the primary use is a gas station. The tent will be located in the parking lot. The temporary vending area is made up of a tent similar to those found at a farmers market and tables to show the retail items and will be set-up to offer walk-up sales and service. Sales and service will be generally provided every day of the week and weekend between the hours of 10:00 am and 7:00 pm. Parking for clients will be provided at the same location and vehicular ingress and egress to the site is provided from Rainier Avenue Sand S 3'd Street. The vending tent will be taken down each day over night and put back up the following day. The following Tier 1 Temporary Use Permit is hereby approved and subject to the following conditions: City of Renton Department of C unity & Economic Development A, SIDDIQ MUMIN ENTERPRISES: SPORTS RETAIL VENDOR Temporary Use Permit DATE OF PERMIT: January 2, 2014 CONDITIONS OF APPROVAL: istrative Temporary Use Permit LUA14-000001, TP Page 2 of 2 1) A City of Renton Business license must be obtained for operation. The applicant applied for a permit and it is in review. This permit will allow the activity without a business license as one has been applied for, but if the business license application is denied this permit becomes voided and the operation must cease. 2) The sales, or Siddiq Mu min Enterprises, cannot stay at the location permanently and must be taken down overnight daily as proposed by the applicant, except for a special event where the unit is allowed at the same location for up to 72 hours. 3) The temporary sales location will cease by the end af February 28, 2014. 4) The temporary safes location will stay on the property of 300 Rainier Ave Sand not use public right-of-way for any activity. 5) Signage for the temporary use cannot create hazards for pedestrians, vehicles driving in the street or users of the gas station, or other hazards. Temporary signage other than that on or within the tent will need to be approved by City of Renton Code Enforcement (phone number 425-430-7438). 6) The site occupied by the temporary use shall be left free of debris, litter, or other evidence of the temporary use upon completion of removal of the use or when the operation of the use ceases to exist. 7) The site occupied by the temporary use shall be restored to the original condition when the use ceases to exist including restoration of site elements such as, but not limited to, landscaping and parking stall striping. DATE OF DECISION ON LAND USE ACTION: SIGNATURE: r T. Henning, AICP, Planning Director Planning Division 1 f 1.//L} ' Date APPEALS: Appeals of permit issuance must be filed with the City of Renton Hearing Examiner by S:00 p.m. on January 16, 2014. Appeals must be filed in writing, together with the required fee to the City of Renton Hearing Examiner, City of Renton, 1055 South Grady Way, Renton, WA 98057. City of Renton Municipal Code Section 4-8-110 governs appeals to the Hearing Examiner. Additional information regarding the appeal process may be obtained from the Renton City Clerk's Office, (425) 430-6510. City of t<enton Print map Template ---------------- 0 1:1,577 131 0 66 131 f'cc\ VVGS _ 1984_ We·o _ Mercator _Auxiliary _Sphere City of Re:rrt O lid.> Finance & IT Division City and County Bour~dary J 0•1cr LO [ rJ Crty cf Rer1i::m . Addresses p ( J · Parcels r· 0 fo J E'.., C IZdA i \ -, -s t~\ )'tr ~ -N S1ddi-ct /vluh. rJ f,Jt,1 ;:=:co'="===-t::1 =-===':':===-=======--------'=:____::::_::===----Information Technology -GIS T~rs rr.a.J is a u5er gcnr.r~lec st~trc ou;pul fro1Ta~ ln:em,c,I ma,::,pirlg site and R e.1ton !\'1 ap Su pp ort@Rcn lonwa .gov 12/30/2013 rs for 11c:ercnce only ·~:ata lc.yers that appear on lh:s map may or m<1y not be a::::urate, cu,1ent. or olhaJ'Wise celkl:Jle THIS MAP IS NOT TO BE USED FOR NAVIGA'ION City of Renton Print map Template I I rlegend , / 330 Raiaie1 A,_,_s------,------i 1 [~~y ~:~:~:,::: Boundary l_ af S \ C G '] 7 J L Q L -( -I \J 0 /J' ! ;ddresses O (' 0 f U ( 'C.. d . I. Parcels r ! 16 1 : 019 . 7 )\L ;6Fee< t '/ r s A l-r -t ( s:_l c11_1 r y~ u MI ,IJ WGS_ 1984_Web_Meccatoc_Ao,ilia1y_Sphece e :A I __) I:: l~{e ,-F / r~ ... City of Re1fto fl Li Finance & IT Division Information Technology GIS RentonMapSupport@Rentonwa.gov L1 313012013 This r:1;ip 15 a use.-generated static o:.ilpu\ !roman Internal mapping SJte. a.en. 1s 1or reference 01ly. Dal8 layers lhal appear on this map may or may riol be aCTJJrate, ourrenl, or olhE!'Wise reliable THIS MAP IS NOTTO BE USED FOR NAVIGATION --- RECEIPT EG00017384 BILLING CONTACT SIDDIQ MUMIN SIDDIQ MUMIN ENTERPRISE 3175 S HOOVER ST, 375 LOS ANGELES, CA 90007 REFERENCE NUMBER FEE NAME . ---~-·~ LUA 14-000001 PLAN -Temp Use -Tier 1 Technology Fee Printed On: 1/2/2014 Prepared By: Laureen Nicolay TRANSACTION TYPE ,. Fee Payment Fee Payment of Transaction Date: January 02, 2014 PAYMENT METHOD - Cash Cash SUBTOTAL TOTAL •. AMOUNT PAID - $75.00 $2.25 $77.25 $77.25 Page 1 of 1 DEPARTMENT OF COI ..... UNITY ANO ECONOMIC DEVELOPMENT PLANNING DIVISION TIER 1 -TEMPORARY USE . DATE OF PERMIT ISSUANCE: LAND USE ACTION FILE NO.: PROJECT NAME: PROJECT MANAGER: OWNER: APPLICANT: CONTACT (if other than Owner): PROJECT LOCATION: DATE OF EXPIRATION: PROJECT DESCRIPTION: January 2, 2014 LUA14-000001, TP .. SIDDIQ MUMIN ENTERPRISES: >P8RfS AIL VENDOR Temporary Use Permit KRIS SORENSEN, Associate Planner SANDY RANA, MANAGER RENTON SHELL GAS STATION 300 RAINIER AVES RENTON, WA 98055 SIDDIQ MUMIN ENTERPRISES-SIDDIG MUMIN, OWNER 3175 S HOOVER ST #375 LOS ANGELES, CA 90007 SIDDIQ MUMIN ENTERPRISES-SIDDIG MUMIN, #(310) 422-7791 300 RAINIER AVES, RENTON, WA 98055 February 28, 2014 The applicant proposes to locate a temporary retail vending tent at a property where the primary use is a gas station. The tent will be located in the parking lot. The temporary vending area is made up of a tent similar to those found at a farmers market and tables to show the retail items and will be set-up to offer walk-up sales and service. Sales and service will be generally provided every day of the week and weekend between the hours of 10:00 am and 7:00 pm. Parking for clients will be provided at the same location and vehicular ingress and egress to the site is provided from Rainier Avenue Sand S 3rd Street. The vending tent will be taken down each day over night and put back up the following day. The following Tier 1 Temporary Use Permit is hereby approved and subject to the following conditions: City of Renton Hf!/; C C1 0 ,}yi tv: t:1 PJl/'J 1 ~,( ! 5 LAND USE PERMIT MASTER APPLICATION PROPERTY OWNER(S) NAME: ADDRESS: )OO e.. r CITY: ZIP: TELEPHONE NUMBER.: APPLICANT (if other th;m owner) COMPANY (if applicable):. ADDRESS:1 \ l \ s • t CITY LoA . . f..A ' TELEPHONE NUMBER: ~ l () L.j"l., L.,-:-J 1 q_ CONT ACT PERSON NAME: s-\ d C: \ COMPANY (if applicable): ADDRESS: CITY: ZIP: TELEPHONE NUMBER AND EMAIL ADDRESS: PROJECT INFORMATION PROJECT OR DEVELOPMENT NAME: .· PROJECT/ADDRESS(S)/LOCATION AND ZIP CODE: KING COUNTY ASSESSOR'S ACCOUNT NUMBER(S): EXISTING LAND USE(S): L , (0 !\_~ fi A.., I ,, ,,) PROPOSED LAND USE(S): EXISTING COMPREHENSIVE PLAIII MAP DESIGNATION: PROPOSED COMPREHENSIVE PLAN MAP DESIGNATION (if applicable) EXISTING ZONING: PROPOSED ZONING (if applicable): ·1--------------------j SITE AREA (in square fee~: SQUARE FOOTAGE OF PUBLIC ROADWAYS TO BE DEDICATED: '; 'J '"; ·1: '.•J, SQU~f~)t?.?,!,11~'.?f(RJ~ATE ACCESS EASEMENTS: .:.' (" / . .'',:,, , , . . r -~~;._ :~ PRQPOSED RESIDENTIAliDEI\ISITY IN UNITS PER NET AC~E (if~[lplicable). ,. / ,, :; . 'i ~ . ,·-.,. ',(). /.;,: < NUMS!'-Rcflo.,PRGPOSl;:ef L01>S (if applicable} ~~-.---<>~):;;f~i}-'." -->'· ,,• . NUMBER OF NEW DWELLING UNITS (if applicable): 03/11 C PROJECT INFORMATION (continued) ~-~-----~------------. NUMBER OF EXl:3TING DWELLING UNITS (if applicable): PROJECT VALUE: SQUARE FOOTAGE OF PROPOSED RESIDENTIAL BUILDIN_GS (if applicable): IS THE SITE LOCATED IN ANY TYPE OF ENVIRONMENTALLY CRITICAL AREA, PLEASE INCLUDE SQUARE FOOTAGE (ifapplicabl.e): SQUARE FOOTAGE OF EXISTING RESIDENTIAL BUILDINGS TO REMAIN {if applicable)> . SQUARE FOOTAGE OF PROPOSED NON-RESIDENTIAL BUILDINGS (if applicable): SQUARE FOOTAGE OF EXISTING NON-RESIDENTIAL /3UILD1NGS TO REMAIN (if applicable): NET FLOOR AREA ON N_ON-RESIDENTIAL BUILDINGS (if applicable):· NUMBER OF EMPLOYEES TO BE EMPLOYED BY THE NEW PROJECT {If applicable): D AQUIFIER PROTECTION AREA ONE D AQUIF/ER PROTECTION AREA TWO D FLOOD HAZARD AREA D GEOLOGIC HAZARD D HABITAT CONSERVATION D · SHORELINE STREAMS & LAKES D WETLANDS LEGAL DESCRIPTION OF PROPERTY (Attach legal description on separate sheet with the following information included) sq. ft. sq. ft. sq. ft. ·sq.ft. sq. ft. . SITUATE IN THE QUARTER OF SECTION __ , TOWNSHIP __ , RANGE __ , IN THE CITY OF RENTON, KING COUNTY, WASHINGTON AFFIDAVIT OF OWNERSHIP /.-id, ·1, (Print Name/s) 0 , -declare under penalty of perjury under the laws of the State oi Washington that I am (please ck one) __ .the current owner of the property involved in this application or __ · the authorized· representative to a_ct for a corporation (please attach proof of authorization) and that the foregoing statements and answers herein contained and the information herewith are in all respects true and correct to the best of my knowledge and belief. Date STATE OF WASHINGTON) ) ss COUNTY OF KING ) Li __ \t,_,.CTT_, "n_ -'---•-'"' APPLICATION FOR r,TY OF RENTON BUSINESS 'cfiENSE FILLOUTT FORM COMPLErfitof:',9 (INCOMPLETE APPLICATIONS WILL NOT BE PROCESSEJ5J"1 ; 6/V'OII; D[c 3 ,, COMMERCIAL By 1 ,({}; . Business CANNOT operate until the application has been approved ~c·~o,-- 0 '· THE APPROVAL PROCESS TAKES 1-2 WEEKS , •"" - GENERAL BUSINESS LICENSE Required: Every business enterprise, including those with a temporary or portable sales location, shall obtain, from the Fiscal Services Division, a general business license for the current calendar year. The license shall be nontransferable. Reference Renton Municipal Code Title 5 Chapter 5. Busin7ss Name & Physical ocation: ,,. ~S=-'-1~d.....,~1-'-1'-=-~u"'--'M_1~~"'=-_,__,._,_.Ll.C-Pr~1s 0 300 €?A\10er, Av,:,g -.S:: Business T~lephon~ #: '3 JD 4] '2.:-:::Z) q Mailing Address (Please check if same as above) D Legal Owner(s), of the Business, Name and Address: ' , s , d,;;l> 5 M U,, M, N Owner's Telephone#: 3lO <-1 J 2 ..:. ::r::i , WA State UBI#: b 03 3 (q I -/ 3 '] Contractor's Lie.# (if applicable) _________ _ Have you previously had a Renton Business License? __ _ Is your business door-to-door solicitation/peddler?---- {if so, please stop and complete a Peddler Permit Form) Are you a non-profit entity? __ If so, please provide Form 501 c}(3) Date Business is Expected to Open In Renton: "-"-/---'-LL/--"., Emergency Name & Telephone Number (other than o er) 1.5:d.J,q lt/\u.10i,J 3·10 '-12,J_;-11'; DE~CRIBE TYPE OF BUSINESS IN DETAIL: \ ' Business License Fees r-;;_; I ur e. +o 0 b+o:',f') -:. t,51)., D -' feJ""<{J Estimate hours worked for 1 full year from date business is expected to open: t ,)<; OJ (this includes all hours worked by owners, family, employees whether paid or unpaid) tt) "-_ (I) Estimated Total Hours Worked: 0- !f hours are over 11920 complete Section 1 below. !f hours are under~ pay the amount in Section 2 below. Section 1 Section 2 Over 1,920 hours: Calculate business license' fee ~s follows . 1,920 hours or Less a. Multiply estimated hours worked X .034 = $ Minimum License Fee b. Plus Base License Fee of: $ 45.00 $65.00 (license fee) $45.00 (base fee) Total Business License Fee Due: Add Line a+ Line b: $ TOTAL DUE: $110.00 I hereby swear or affirm that the statements and infonnation furnished by me on this application are, to my knowledge, accurate, true and complete. I acknowledge that these statements and infonnation are public records that may be available for public inspection pursuant to RCW 42-56, the Public records act, and that any inaccurate, false, or incomplete statement may be a crime under the RCW and/or RMC, punishableunderRCW .92 and/orR.M:C 1-3-1. ( Print Name: "1 Email Address: ( i cl A, }ft/\ 1 J Mi d f ¥"· I:, b ' C () M Return Completed Application with City of Renton License Division payment to: 1055 South Grady Way Renton, WA 98057 l FOR OFFICE USE ONLY I I AMOUNT PAID I DATE I Commercial 12/2012 HOW PAID Phone:"' i "'-'--'-'---'-">__,.,__,__,_.,_./-_ Phone: 425-430-6851 Fax: 425-430-6983 Email: licensing@rentonwa.gov I NAICS # I APPLICATION# CITY OF """ • -· RECEIVED OEC 31 ·20\3 I I 0 BU4LDING DIVISION CITY OF REtHotl BLDG D 1055 S GRADY WAV REtHOH, MA. 98057-323 425-430-6918 /[RMIIIHL ID,: HERCHAIIT #: UISA 0017340108001515677001 8002515677 111111111Ji1B75B EXMl/li SALE SWIPED RECORD: 6 DATE: Dec 31., 1J BMCH: 000282 m: m1101501 ltlU: 000008 II/i: 11:15 AUTH:957000 UISA mH ID: 163365735075014 APPROUAL 957000 T L · · .· $7 SIDDIQ tllMIN CUSTOMER COPY APPLICATION FOR C11Y OF RENTON BUSINESS 'tliENSE FILL OUT THIS FORM COMPLETfi.'Vo,c: F/ (INCOMPLETE APPLICATIONS WILL NOT BE PROCESSEiS]"i / gtvro/1; fll:'r, ,. cc .J 1 . COMMERCIAL By :!(};. iness CANNOT operate until the application has been approved ~D, .. -o.. . ... ' THE APPROVAL PROCESS TAKES 1·2 WEEKS c ,·n - Required: Every business enterprise, including those with a temporary or portable sal~'.s · ~ Fiscal Services Division, a general business license far the current calendar year. The license rence Renton Municipal Code Title S Chapter 5. ] 1.:--7) "J ,me as above) D l~me and Address: ,CN WA State UBI#: 0 03 3 (;:, I -; 3 'J Contractor's Uc.# (if applicable) _________ _ Have you previously had a Renton Business License? __ _ Is your business door-to-door solicitation/peddler? ___ _ (If so, please stop and complete a Peddler Permit Form) Are you a non-profit entity? __ If so, please pro":'ide Form 501 c)(3) Date Business is Expected to Open in Renton: .....,."+..,_L+-'>-< Emergency Name & Telephone Number (other than o ner) 1. 5 :dd C t,J\ . .,J "3 I() 1-/Z. -1,"\ .f:'rs., + :', I \ ' owner's re1ephooe "' ) 11 , ·I] ) ._;) "') "i Business License Fees r-=;;_; I ur e. +o obrn'i,i-_ t,5(). ') -' fg_(Y)p Estimate hours worked for 1 full year from date business is expected to open: it ds· co (this includes all hours worked by owners, family, employees whether paid or unpaid) '4 ]S :JJ Estimated Total Hours Worked: !f hours are over 119'20complete Section 1 below. !f hours are under 1 920 pay the amount in Section 2 below. Section 1 Section 2 Over 1,920 hours: Calculate business license fee as follows 1,920 hours or Less a. Multiply estimated hours worked X .034 a $ Minimum License Fee b. Plus Base License Fee of: $ 45.00 $65.00 (license fee) $45.00 {base feel Total Business License Fee Due: Add line a+ Line b: $ TOTAL DUE: $110.00 I hereby swear or affirm that the statements and infonnation furnished by me on this application are, to my knowledge, accurate, true and complete. I aclmowlc:dge that these statements and information are public records that may be available for public inspection pursuant to RCW 42-56, the Public records act, and that any inaccurate, false, or incomplete statement may be a crime under the RCW and/or RMC, punishableunderRCW .92and/orRMC 1-3-1. ( SIGNATURE:._.,~~l<'i...,.-dlc:--r....::._u..._.<'.lil.;A.!IO..,------------r::::--"r--/--c::---- Print Name: 1 M Email Address: ~; cl A, j' h I/ Mi Return Completed Application with payment to: FOR OFFICE USE ONLY AMOUNT PAID Commercial 12/2012 t0 0+ p. hci), c ~ 0 City of Renton License Division 1055 South Grady Way Renton, 1/JA 98057 DATE HOW PAID Phone: 425-430-6851 Fax: 425·430-6983 Email: licensing@rentonwa.gov NAICS# APPLICATION# Q J.2).2t); 3 057 PJ,1<.. S,l)lJJ{}.. )1,.qvt'-P€-P--M, ~SltJN 7a U sc=-C)UP-fl-~ST/4:JdY-'7 f{ fi~ f1wf-f'/l...cJ,'Tl1SsFp To J<t=-t<'-P 7,,.,,c. #IE,!} C.2-M;JJ~ ~~rz?U~ S/)!V'JJ y /2./}JY/i {/fJ/?)-1,9 C...!'/L /21-r,rTcJrJ y,1c-).-~ City of Renton Print map Template Notes 330 Ra1n1er Ave S Legend / City and County Boundary _ J < \ ') I Other LO { .) (.__.'\..._ l~-J Ciiyo-:'Rer110·1 p r0p0 { E'_(J · 1 -, -s l'\\ /"tr WGS_ 198'1_V\/eb_Mercator_Auxiliary_Sphere ' ·1 (' --\ \ A J.. J t ~-----~ c}-\ C)C{ .. ) ~~t V~\~~>~~:::'::':::c::f\)=t,=· =·,J=j = C. 'tty of R-e·n· '"''to·n· '1 '.nformatlon Technology. GIS n,s rrap IS a user 9enerated slat,c oulpJ\ 'roman l1twne\ rrarr:1ng ~' ·c ;m(i ___ --" ,s rc,r rde,re:,nce cnly. Jata layers '.'1al a;opearon tr1s rnap rn2y -:r rv,y Ni: he I RentonMapSuppor1@Rentonw,i_gov acwrate, -current, o, c-thewise rehable 0 Addresses Parcels 1:1,577 RdA ' 131 0 66 131 ~eet , Finance & IT Division 12130/2013 THIS MAP IS NOT TO Of. USED FOR NAVl(;Al ION >If/ A-l( v;l/~~ . r o (A""" -rr~ • ~II' J.. fJt tekr1/ros+- ~ vp,w-_b 1>w ( a ~ Lv t::,_ c.. City of Renton Print map Template Notes 330 Rc1inier Ave S 16 City of Retffori hnance & IT Division Legend City and County Boundary Other [~J City cf Renton Addresses Parcels ' I Leif S1 ll J7; ?_0)_ i~ fr Of DI'<-d \J ~----------------- Stdd1cp Y---'lu»1 ,0 £ JJte • F_' r~ Information Technology-GIS RentonMapSuppuri@Rentariwa.gov 12130/2013 T1'1.s m2p i.s a user genecaled static ou'.cut fmran lntarnel riap;iing site and 1s for reference only Data layers lhat appear on tn,s map may ~·r nay nol be accurate, curren'. or uth,wi~e re·.i~le TI-JIS Mi\0 IS NOT TO BE USED f'OR NAVIGATION • DEPARTMENT OF COMMUNITY AND ECONOMIC DEVELOPMENT -------~ ABATEMENT AGREEMENT TEMPORARY USE City of Renton Planning Division 1055 South Grady Way, Renton, WA 98057 Phone: 425-430-7200 Fax: 425-430-7231 ~.~~.\~,-~ being the Applicant for the Temporary Use Permit at 3 0 0 R A \ . _r,,)"<, C: ~ Ave Hereby authorize the City of Renton to summarily eliminate the Temporary Use and all evidence of the use if it has not been removed as required by the terms of the permit. I also agree to reimburse the City for any expense incurred in abating this Temporary Use. Signature: khM~~ ,~ 5 l, d d \ 9 tJ\ 1 1 M \ 0 11-)°?>b/11 Print Name: Date: I I STATE OF WASHINGTON ) ) ss COUNTY OF KING } -2- H:\CED\Data\Forms-Templates\Self-Help Handouts\Planning\Temporary Use Tier 1.doc 08/12