Laserfiche WebLink
2o <br /> <br />; MARION COUNTY <br /> BUILDING INSPECTION <br /> Community Development Center · 285 Church St. NE * Room 132 · Salem, Or, gon 97301 <br /> Office Hour~: 8:00 - 4:30 Phone: 588-5147 24 Hour Code-A-Phone: 588-7904 <br /> <br /> APPLICATION FOR EXEMPT STATUS <br /> <br /> FOR AN AGRICULTURAL BUILDING ON A COMI~RCIAL FARM <br /> <br />Building, 495 State Street, Salem) <br /> <br />Are you located within the Urban Growth Boundary? <br /> <br />Describe in detail zour commercial farm en.terprise: <br /> <br /> - .) <br /> <br />Describe in detail the use of and/or commodities stored in the proposed structure: <br /> <br />5o <br /> <br />Is the proposed structure located within a flood plain? Y N <br /> <br />Does the proposed structure have any of the following systems? <br />Electrical Y A-"N Plumbing Y__ N ~ Heating/Cooling/Ventilation <br /> <br />Where will restroom facilities be provided? <br /> <br />Will persons be working in the structure more than a total of 144 hours, dnring any <br />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 />What is the distance from the proposed structure to property lines and/or other <br />structures? Front Rear <br /> Left Side Right Side Other structures <br /> <br />11. <br /> <br />This application will not be considered complete without a site plan. See attached <br />site plan requirements. <br /> <br />I certify that I have read this application and state that the information given is <br />correct. I agree to comply with all state laws and county ordinances relating to building <br /> <br />construction. <br /> <br /> SIGNATURE <br /> DATE <br /> PHONE <br /> <br />NAME (Please print) . <br /> <br />gTREET ADDRESS <br /> ,6'~,.,,, ~ ~//~ ,"3~ 7232.~--- <br />CZT~ STAT~ Z~P <br /> <br />OFFICE USE ONLY <br />PLANNINO DIVISION: <br /> Validated By: <br /> <br />COMMENTS: <br /> <br />SIT~3S NO. <br /> Approved: <br /> <br />Date: <br /> <br />BUILDINO DIVISION: <br /> Validated By: <br /> <br />COMMENTS: <br /> <br />Approved: Denied: Date: <br /> <br />APPROVED: DENIED: STRUCTURAL PERMIT IS REQUIRED <br /> Other permits required: Electrical, Plumbing, Mechanical, Septic <br /> <br />MC 15-76 <br />REV 8/94 <br /> <br /> <br />