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O_ - (\CVfl- ,1C-1 <br /> Agricultural or Forestry Buildine Exemption Certificatioq D LE C H II V I <br /> Equine Facility Exemption Certification <br /> DEC 14 2023 <br /> Marion County Public Works—Building Inspection Division DEC <br /> ivaticill 5155 Silverton Rd.NE, Salem Oregon 97305 <br /> [Uten[y Phone: (503)588-5147 Fax: (503)588-7948 Email:build ,RZON OUNTY <br /> o R I C a N BUILDING INSPECTION <br /> // <br /> Site Plan is Required—see attached information <br /> Owner/applicant name: er.r,✓ti- l h F� Phone: eciOnz--7073 Email: kNig .art " <br /> Mailing address: 2$ 9(Q lett City/State: �,�d r,� n Zip: ci'IonZ <br /> Job site address: . Nq(, L 14- L vt City/State: teL rc..^,,, 0(t. Zip: C. <br /> Parcel Information:Parcel Size: 3,iIZ etervg Parcel No.: I Zone: <br /> Proposed Building Information p <br /> Describe specific use of thebuildingy and items contained within `r�4 (Dka..Ip lvlr� tic(( ��- t)$Ede +o <br /> Sfor-- 1M R -kz. ��' 4 r ' 4 ta/F 4 L-"��ba{t jJ <br /> Building Dat&Length: y2, Width: 3� Area: /z y ight: <br /> Type of Exemption: o Agricultural Building o Forestry Building o Equine Facility(Provide information below): <br /> What is the proposed maximum number of people(includingemployees,owners,etc.)that will bepresent in the buildingat <br /> P P P P <br /> any one time? 9 <br /> Will this structure be used by the public at any time? oYes XNo <br /> Is the proposed structure located within a floodplain? oYes No <br /> Is the building located on/used in the operation of a farm? gYes o No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes )4 No <br /> Is the use of the structure or the items within it used for anybusiness or commercial activities? oYes No <br /> 1ti <br /> If yes,please explain: <br /> Agricultural/Equine Exemption Criteria—Select all that apply: <br /> Sit Storage,maintenance,or repair of machinery,equipment,and supplies used on this farm <br /> �acRaising,harvesting,or selling crops raised on this farm <br /> ❑Feeding,breeding,management,or sale of livestock,poultry,forbearing animals, or honeybees <br /> o Dairying or the sale of dairy products produced on this farm <br /> o Other agricultural,horticultural,or animal husbandry used <br /> ❑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 °Yes , No(Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building? Wes o No <br /> Will there be farm animals(poultry excluded)within the building at any time? oYes KNo <br /> Will there be farm animals(poultry excluded)on the slab at any time.? oYes ANo <br /> Will the building be used for storage of feed,hay,or straw? Kies ❑No <br /> Will the building be used for major repair of motor vehicle equipment? oYes .No <br /> Heating/cooling/ventilation/mechanical oYes )tNo <br /> Septic oYes '>ttl No (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) AYes gNo <br /> Page I of 5 <br /> 60/T0 39Vd 0880186E05 L17:61 ETOZ/17T/L0 <br />