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Agricultural or Forestry Building Exemption Certification 7. Equine Facility Exemption Certification C F E Marion County Public Works-Building Inspection Di Marion 5155 Silverton Rd.NE, Salem Oregon 97305. 11 Count Phone: (503) 588-5147 Fax: (503)588-7948 Email:buildingn,c 'onl rilsO ">"`"} OREGON• TY Site Plan is Required-see attached information MA 10�! ��r1� � O 1 A BUI!_UING II,JSP- Owner/applicant name: A-K— - Phone: 553' 8'2 5j Email:Z'A 11 1 9.° Mailing address:12.012 AR.N DT RA.. (4 f,, City/State: Zip:1--kart) 2— Job site address: 9-2O1,2- NIDT A . km., City/State: 0-AZ Zip: vZ Parcel Information: Parcel Size: Parcel No.: Zone: Proposed Building Information Describe specific use of the building and items contained within Al, -- P4Li pro e oti - ail PY 4 c.'Clike,i- Building Data:Length: 200/ Width: 101 Area: Height: Type of Exemption:"''''111gricultural Building ❑Forestry Building o Equine Facility(Provide information below): What is the proposed number of people(including employees, owners, etc.)that will be present in the building at any one time? 4 avnovEDWill this structure be used by the public at any time? ❑Yes. 'No Is the proposed structure located within a floodplain? oYes .No Is the building located on/used in the operation of a farm? es o No Is the proposed structure a residential dwelling or manufactured home? oYes *No Is the use of the structure or the items within it used for any business or commercial activities? oYes No If yes,please explain:_ Agricultural/Equine Exemption Criteria-Select all that apply: • *Storage,maintenance,or repair of machinery, equipment,and supplies used on this farm ❑Raising,harvesting,or selling crops raised on this farm ❑ Feeding,breeding,management, or sale of livestock,poultry,forbearing animals, or honeybees ❑ Dairying or the sale of dairy products produced on this farm Other agricultural,horticultural, or animal husbandry used ❑ Stabling,training,riding lessons, or clinics (Complete Equine Exemption Criteria) #of stalls/horses #of stalls/horses for personal use only #of stalls/horses used for commercial or trade purposes including boarding,training,rentals, clinics,shows, etc. Which of the following systems will the proposed structure have? Electrical oYes jNo (Complete Electrical Wiring Criteria) • Will there be a concrete slab either within or adjacent to the building? 'es o No. Will there be farm animals(poultry excluded)within the building at any time? oYes)(No' Will there be farm animals(poultry excluded)on the slab at any time? oYes )<No Will the building be used for storage of feed,hay, or straw? es ❑No Will the building be used for major repair of motor vehicle equipment? oYes'No Heating/cooling/ventilation/mechanical oYes .No Septic oYes No (Any yes answer will require a separate permit) Plumbing(Please specify fixture type) oYes No Page 1 of 6