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Agricultural or Forestry Building Exemption Certification <br /> ,_ ;: Equine Facility Exemption Certification <br /> Marion County Public Works-Building Inspection Division <br /> Marion 5155 Silverton Rd.NE, Salem Oregon 97305 <br /> County Phone: (503)588-5147 Fax: (503) 588-7948 Email:building@co.marion.or.us <br /> OREGON Owner/applicant name: U 3e\SZ i-A"Ak 1 l LLB Phone:,c)a,3-7 q?-Li-1 6D Fax: <br /> � f <br /> . Mailing address: I L I)S BB A-{--�-p_v,I�p �1 I I V L City/State:Giec-Joo\S O Zip: cA-mace <br /> Job site address: 4 Da, 3,l-\± L� ��r City: p� axe S Zip: C7 <br /> �I a] � P � CC' <br /> Directions to the site: Aacia& ` 1 S-Ve ci <br /> Proposed BuildingInformation VE <br /> AFT1 <br /> P <br /> 1. Site plan is attached(required): Yes o No U <br /> 2. Type of Exemption: Agricultural Building o Forestry Building o Equine Facility(provide information below): <br /> o Total number of stalls or equivalent number of horses: <br /> o Total number of stalls or equivalent number of horses limited to personal use only: <br /> o Total number of stalls or equivalent number of horses anticipated to be used for commercial or trade purposes <br /> inc.boarding,training,rental,haul-in, clinics,shows,etc. (consider future plans): <br /> 3. Is the use of the structure or the items within it used for any business or commercial activities? Wes o No <br /> If yes,please explain: , \e-v-)t 4- e\*vc ox* r-p\->o`A r <br /> 4: Describe use of the building and items contained within: hZj i.),) <br /> 5. Is the property in farm or forest deferral? 'kYes o No <br /> 6. Is the proposed structure located within a floodplain? oYes No <br /> 7. Will the proposed structure have any of the following systems? (If yes, separate permits are required for each system): <br /> Plumbing oYes No If plumbing will be installed,what type of fixture(s)? <br /> Electrical AYes o No Tel 1,NA— ` , fp( 6_e <br /> i <br /> Septic oYes No <br /> Heating/Cooling/Ventilation/Mechanical oYes No <br /> 8. Will this structure be used by the public at any time? oYes ,No <br /> 9. What is the proposed maximum number of people(including employees,owners, etc.)that will be present in the <br /> building at any one time? 5 <br /> 10. Where will restroom facilities be provided? I r <br /> 11. Is the proposed structure a manufactured home? oYes •yi No <br /> 12. Building Data:Length: _ Width: Area: Height: <br /> 13. Parcel Information:Parcel Size: Parcel No.: Zone: <br /> Page 1 of 5 <br />