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2 3- 0-0 6127(9 e <br /> I Agricultural or Forestry Building Exemption Certification <br /> D 'D n Equine Facility Exemption Certification � I © [ Ii V <br /> i t ' I: on' County Public Works—Building Inspection Diviissi6n <br /> Marion o U 5155 Silverton Rd.NE, Salem Oregon 97305 <br /> County - phone: (503)588-5147 Fax: (503)588-7948 Email:building@cb.niariair6i.ti V 202 <br /> O R EGO N <br /> MARION COUNTY <br /> Owner/applicant name: ahe ' YY1 171 (14 Phone: 503 'I.31 2zye., BUTT ING INSPECTION <br /> Mailing address: 141 g( ielh' ler he N E City/State: IA ubbar t QP Zip: 9 703 Z <br /> Job site address: J 9 Ls, Pi rhll,' Laic N1= City: Bubb,reci Zip: 77032 <br /> Directions to the site: ;Alt e_ rood 421 tell i' La rye .4 IQ qo . Pt rel li f je o s Co'vnbg(o k I Fo tioal <br /> Proposed Building Information <br /> 1. Site plan is attached(required): kiYes o No <br /> 2. Type of Exemption: )(Agricultural Building o Forestry Building o Equine Facility(provide information below): <br /> o Total number of stalls or equivalent number of horses: <br /> o Total number of stalls or equivalent number of horses limited to personal use only: <br /> o Total number of stalls or equivalent number of horses anticipated to be used for commercial or trade purposes <br /> inc.boarding,training,rental,haul-in,clinics,shows,etc.(consider future plans): <br /> 3. Is the use of the structure or the items within it used for any business or commercial activities? oYes 'No <br /> If yes,please explain: <br /> 4. Describe use of the building and items contained within: 1--etalin3 r nA yrlc racy,piny i4 e1) Le cl eddb c(Z <br /> 5. Is the property in farm or forest deferral? '4Yes o No <br /> 6. Is the proposed structure located within a floodplain? oYes VNo <br /> 7. Will the proposed structure have any of the following systems?(If yes,separate permits are required for each system): <br /> Plumbing oYes /No If plumbing will be installed,what type of fixture(s)? <br /> Electrical oYes g No <br /> Septic oYes ' No <br /> Heating/Cooling/Ventilation/Mechanical oYes -lb No <br /> 8. Will this structure be used by the public at any time? oYes KNo <br /> 9. What is the proposed maximum number of people(including employees,owners,etc.)that will be present in the <br /> building at any one time? <br /> 10. Where will restroom facilities be provided? /4/40.7 hoQts-ft <br /> 11. Is the proposed structure a manufactured home? oYes brrNo <br /> 12. Building Data:Length: 3(o Ft Width: 3O FT Area: /Die f?2- Height: /a F7 <br /> 13. Parcel Information:Parcel Size: 39 oC r e-S Parcel No.: ©y I W 2 00 a 0 16 a5 Zone: p U <br /> OYI W aqA oco you <br /> Page 1 of 5 <br /> pi retn1Sbp22 ® y'MG;L.- Co.- <br />