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c9t-l-f/o3 \-1 <br /> s Agricultural or Forestry Building Exemption Certific ' C LP' [, <br /> Equine Facility Exemption Certification <br /> Marion County Public Works—Building Inspection Divisi MAR 19 202'4 <br /> Marion5155 Silverton Rd.NE, Salem Oregon 97305 <br /> County Phone: (503)588-5147 Fax: (503) 588-7948 Email: building@co.m. tdn.9 o. COU\ITY <br /> co ;R ,E , o N buILUI G 1NSFECTION <br /> Site 1P�lan is Required—see attached information <br /> Owner/applicant name: LOC&S SGiv ac95.10.A.` Phone: 60-6 SO7 3°32 Email: I 5 Chv x1 c3 QC f 1 <br /> Mailing address: PO O->e 11.5 1 City/State: 5. I g Zip: q75 ( y <br /> Job site address: rb2\\ �\c�y �o^ City/State: S (,Q eir 3-w1ONK. Zip: '(7 3 e 1 <br /> Parcel Information: Parcel Size: Parcel No.: Zone: <br /> Proposed Building Information <br /> Describe specific use of the building and items contained within Az ° L.L&q ç - <br /> k-re9 C Qc�--►^s <br /> E tn- 4-L 'r CIS � ►M J <br /> Building Data: Length: / Q 6 Width: � C7 Area: ((3O C Height: a B <br /> Type of Exemption.Igricultural 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 building at <br /> any one time? 6 <br />-- -Will this structure be used by the public at any time? oYes 21Vo iip.movio <br /> Is the proposed structure located within a floodplain? ❑Yes �I to <br /> Is the building located on/used in the operation of a farm?4res ❑No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes -ttf-No <br /> 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 /> 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 /> o 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 des o No (Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building?- es o No <br /> Will there be farm animals(poultry excluded)within the building at any time?c EYes ,-No <br /> Will there be farm animals(poultry excluded)on the slab at any time? oYes .4-No <br /> Will the building be used for storage of feed,hay, or straw? dyes o No <br /> Will the building be used for major repair of motor vehicle equipment? oYes aS:rNo <br /> Heating/cooling/ventilation/mechanical oYes <br /> Septic oYes 41-No (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) oYes <br /> Page 1 of 5 <br />