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~P~.IC~TION FOa EX~ S~ATUS <br /> FROM THE STRUCTUE~ SPECIALTY CODE IVlARION COUNTY <br /> ~oa ~ ~eaz~ ~UZ~ZNe ON ~ CO~aCZ~ ~ 9U~LD~N2 INSPECTION <br /> <br />Is this pro~rty classified as fa~ deferred? Y ~ N __ <br />(You must provide a computer printout verifying special assessment for farm use. <br />This can be obtained at the Marion County Assessor's Office located in the Frankli~ <br />Building, 495 State Street, Salem) <br />Are you located within the Urban Growth Boundary? Y -- N ~ ~ <br />Dg~cribe.in detail your oo~ercial farm ~nterpr~sp, ~ P~m Q ~9 <br /> <br />D~scribe in detail the use of and/or colodities stored in the proposed structure: <br /> <br />5o <br /> <br />Is the proposed structure located within a flood plain? Y N X <br />Does the proposed structure have any of the following systems? <br />Electrical Y ~ N Plumbing Y ~ N__ Heating/Cooling/Ventilation Y__ N S <br />Where will restroom facilities be provided? ~0~ <br /> <br />will persons be working in the structure more than a total of 144 hours, during any <br />week of the year? Y __ N ~ <br />Is this structure used by the public at any time? ¥__ N ~ <br />Explain: <br /> <br />10. What is the distance from the proposed structure to property lines and/or other <br /> structures? Front 40 Rear ~']~ <br /> Left Side ~ Right Side ~ Other structures ~ <br /> <br />11. 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 />NAME (P~ease Drint~ <br />STREET ADDRES'S <br /> <br />CITY STATE ZIP <br /> <br />OFFICE USE ONLY SITUS NO.~ ZONE: ~/~ <br />PLANNING DIVISION: AW <br /> Validated BylaW__ Approved: / Denied: -- <br />COMMENTS: ~ .~/~'~ ~ zg~ <br /> <br />BUXLDINO DIVISION: <br /> Validated By:__ Approved: Denied: <br /> <br />MAP: .~'-/ <br />Date: <br /> <br />Date: <br /> <br />COF~tENTS: <br /> <br /> APPROVEDI <br /> DENIED: ./~----~-~ S~J~J~]~L PERMIT IS I~QUIRED <br />MC 15-76Other permits required.~tr~hing~Mechanical, Septic <br />R~V 8/94 <br /> <br /> <br />