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MARION COUNTY <br /> BUILDING INSPECIION <br /> Senator Building ,, 220 High Street NE · Second Floor · Salcm, Oregon 97301-3670 <br /> Office HOurS: 8:00- 4:30 Phone: 588-5147 24 Hour Code-A-Phone: 588-7904 <br /> <br /> APPLICATION FOl~ EXEMPT STATUS <br /> (FROM '&~. STHUCTURI%L ,PECiP. LTY CODE) <br /> FOR AN A~RICULTURAL BUILDIN~ <br /> <br />PaoPOSED m T ON: CRk X.*. TAX a*mm : <br /> <br />IS this property classified as farm deferral by the Marion County <br />Assessor Department? (You must provide a copy of your tax statement <br />showing the farm deferral.) Y ,~ N <br />Are you located within the Urban Growth Boundary? Y . ~ N __ <br />Describe in detail the use of and/or co~odities stored in the p~posed <br /> <br /> /_~&u ~C ~J~ located withJ a flood plain? Y X <br /> 4. ~s~he proposed structure <br /> <br /> 5. Does the proposed structure have any of the following systems~ <br /> Electrical MO ~lumbinq ~/FQ Heating/cooling/Ventilation <br /> <br />6. Where will restroom facilities bo provided? ~ <br /> <br />Will persons be working in the structure more than a total of 144 hours, <br />during a~¥ week of the year? Y __ N ~__ <br /> <br />Is this structure used by the public at any time? Y N~ ~ <br />Explain: <br /> <br />10. <br /> <br />This application will net be considered complete without a site plan. <br />See attached site plan requirements. <br /> <br />What is the distance from the proposed structure to property lines <br />and/or other structures? Front ~(~ Left side <br />Hight side !.~' Rear 5~S' Oth~r structures~~ <br /> <br />have read this application and state that the information <br />I agree to comply with all state laws and county ordinances <br /> <br />I certify that I <br />given is correct. <br /> <br />S~GNATURE~ <br /> <br />NAME (Please print) <br /> <br />STREET ADDRESS <br /> <br />NO. Z 7%" MAP: q W <br /> ~ DATE: ~-~_~ -~L- <br /> <br />OFFICE USE ONLY <br /> <br />Planning Division Validation By: <br /> <br />COMMENTS: <br /> <br />Building Division Validation By: ~ ~ <br />COMMENTS: ~ <br /> <br />DATE: <br /> <br /> APPROVED: DENIED: STRUCTURAL PERMIT IS R~QUIRED <br /> <br />7/91 Other permits required: Electrical, Plumbinp, Mechanlcal, Septic <br /> <br /> <br />