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Agricultural or Forestry Building Exemption Certification <br /> Equine Facility Exemption Certification <br /> 6 = County Public Works-Building Inspection Division <br /> Marion ` 5155 Silverton Rd.NE, Salem Oregon 97305 <br /> Country [top 1: I <br /> a c ,c <br /> 8-5147 Fax: (503) 588-7948 Email: building@co.marion.or.us <br /> OREGON <br /> Site Plan is Required-see attached information <br /> Owner/applicant name: £ r'Cr- S; be_ Phone: 5%3 F) mail: 1441 . !4 °P 7a4$ <br /> Mailing address:/ 771i G.T 40 t R.,0 5-4E City/State: S I i.°•till Zip: jt 73 S.I <br /> Job site address: /70 0 Si L"e R. sp. LA N( City/State: S Zip: R )3 EH G <br /> Parcel Information: Parcel Size: (o Parcel No.: Zone: <br /> Proposed Building Information <br /> Describe specific use of the building and items contained within Z'# o Sc.- — 5 k op Il. <br /> f l-u 6-- N 0.5,e lty <br /> Building Data: Length: 5 L Width: 3 0 Area: 21 R fl r Height: ( $ <br /> Type of Exemption: Agricultural Building ❑ Forestry Building o Equine Facility(Provide information below . <br /> What is the proposed maximum number of people(including employees, owners, etc.)that will be present in the buildin at <br /> any one time? „k$..�.. <br /> Will this structure be used by the public at any time? oYes o 7` <br /> Is the proposed,structure located within a floodplain? oYes 424o <br /> Is the building located on/used in the operation of a farm?/ Yes ❑No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes ,rerNo <br /> — Is the use of the structure or the items within it used for any business or commercial activities? des ❑No <br /> If yes,please explain: r- C. t op. <br /> Agricultural/Equine Exemption Criteria-Select all that apply: <br /> Storage,maintenance, or repair of machinery, equipment, and supplies used on this farm <br /> zlfarising,harvesting, or selling crops raised on this farm <br /> o Feeding,breeding,management, or sale of livestock,poultry,furbearing animals, or honeybees <br /> o Dairying or the sale of dairy products produced on this farm <br /> Oer agricultural,horticultural, or animal husbandry used <br /> o Stabling,training,riding lessons, or clinics(Complete Equine Exemption Criteria) <br /> # of stalls/horses <br /> # of stalls/horses for personal use only <br /> # of stalls/horses used for commercial or trade purposes including boarding,training,rentals, clinics, shows, etc. <br /> Which of the following systems will the proposed structure have? <br /> Electrical /es o No(Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building? Xes o No <br /> Will there be farm animals(poultry excluded)within the building at any time? oYes 1lo <br /> Will there be farm animals(poultry excluded)on the slab at any time? oYes „ 'No <br /> Will the building be used for storage of feed, hay, or straw? oYes .itto <br /> Will the building be used for major repair of motor vehicle equipment? oYes <o <br /> Heating/cooling/ventilation/mechanical Xes o No <br /> Septic oYes 4o _ (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) , es ❑No 4-' A o 4943-r5 pi P... A.A. l,z-t <br /> Page 1 of 5 <br />