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S�-2�- a� 0352 --�c�. <br /> Agricultural or Forestry Building Exemption Certification <br /> Equine Facility Exemption Certification <br /> ,406 <br /> Marion County Public Works-Building Inspection Division <br /> Marion 5155 Silverton Rd.NE, Salem Oregon 97305 <br /> County <br /> Phone: (503)588-5147 Fax: (503)588-7948 Email: building@co.marion. . D <br /> OREGON Eg <br /> Sit Plan is Required-see attached information <br /> Owner/applicant name:/?/A& / cavy ex Phone:.3 -l -)6sqEmail/ /kW 3 bdLs PsG14`.-11 <br /> Mailing address: > City/State: Zip: <br /> Job site address: 3/0 g'�i1/�� City/State: iset#zed- a kktk Zip: 9'730- <br /> Parcel Information: Parcel Size: Parcel No.: Zone: <br /> Proposed Building Information <br /> Describe specific use of the building and items contained within tydfint4 ]�r q <br /> Building Data: Length: -3v Width: 3(a Area: Height: <br /> Type of Exemption:)(Agricultural Building ❑ Forestry Building ❑ Equine Facility(Provide information below): <br /> What is the proposed maximum number of people(including employees, owners, etc.)that will be present in the building at <br /> any one time? /[,( <br /> Will this structure be used by the public at any time? oYes ,<No <br /> Is the proposed structure located within a floodplain? oYes $No <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 )(No <br /> Is the use of the structure or the items within it used for any business or commercial activities? oYes kIKNo <br /> If yes, please explain: <br /> Agricultural/Equine Exemption Criteria-Select all that apply: <br /> )(Storage,maintenance, or repair of machinery, equipment, and supplies used on this farm <br /> Raising,harvesting, or selling crops raised on this farm <br /> ❑ Feeding, breeding,management, or sale of livestock, poultry, furbearing animals, or honeybees <br /> ❑ Dairying or the sale of dairy products produced on this farm <br /> o Other 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 yes o No(Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building? )IYes o No <br /> Will there be farm animals(poultry excluded)within the building at any time? oYes %No <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 )(No <br /> Will the building be used for major repair of motor vehicle equipment? oYes No <br /> Heating/cooling/ventilation/mechanical oYes $No <br /> Septic oYes y1Q No (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) oYes )(No <br /> Page 1 of 6 <br />