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Agricultural or Forestry Building Exemption Certification <br /> Equine Facility Exemption Certification <br /> Marion County Public Works—Building Inspection Division <br /> arionhy 5155 Silverton Rd.NE, Salem Oregon 97305CO <br /> 101 Phone: (503) 588-5147 Fax: (503) 588-7948 Email: building�?,co.mar f <br /> OREGON <br /> Site Plan is Required—see attached information <br /> � less , <br /> Owner/applicant name: 'ass, Clays Phone:3(oO-5(p2 •S(o22Email` h�'I. Cpnei <br /> Mailing address: n15 (,�. S, _City/State: 4ntWi lie. `Llp: %130s <br /> �� t � <br /> Job site address: v .S City/State:/State: V 1 Zip:�. ty ��1vY1S � p Cr!°t''1 � <br /> � IS Sfnc�rl e, Pam. <br /> Parcel Information: Parcel Size: �•1.9 Parcel No.:0$2W 3We. pa3OO Zone: U. <br /> U <br /> Proposed Building Information <br /> Describe specific use of the building and items contained within SADY l VA6Livl�1QulOz. 1 or <br /> 0..%r cc -caret. t1/t 0.C.AA t KILMI 6%1\8. (J CLO VILLA71- <br /> _ . <br /> Building Data: Length: tat t Width: 3(p Area: la IIeight: 17 <br /> Type of Exemption: )(Agricultural Building o 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? Z. <br /> Will this structure be used by the public at any time? oYes KNo <br /> Is the proposed structure located within a floodplain? oYes )kNo <br /> Is the building located on/used in the operation of a farm? Ayes ❑No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes KNo <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 /> PI.Storage,maintenance, or repair of machinery, equipment, and supplies used on this farm <br /> o Raising,harvesting, or selling crops raised on this farm <br /> o 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 oYes 7kNo(Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building? Ares o No <br /> Will there be farm animals(poultry excluded)within the building at any time? oYes 51(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 kNo <br /> Will the building be used for major repair of motor vehicle equipment? oYes 511,No <br /> Heating/cooling/ventilation/mechanical oYes %No <br /> Septic oYes KNo (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) oYes XNo <br /> Page 1 of 5 <br />