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BUILDING INSPECTION <br /> 3150 LANCASTER DR NE - SUITE C <br /> <br /> APPLICATION FOR EXEMPT STATUS FROM THE STRUCTURAL SPECIALITY FOR AN AGRICULTURAL BUILDING ON A COMMERCIAL FARM <br /> <br />P OPOSEDLO T,ON.' <br /> <br /> BUILDING SITE ACRES: ~ <br /> <br />1. Is this property classified b~b.e,~A~sessor as farm deferred? <br /> <br />2. Are you located within the Urban Growth Boundary? <br /> <br />t <br /> TOTA~ES FARMED: <br /> <br />3. B~ in describing your commercial farm enterprise, size of operation, and annual profit. If applicable, <br /> provide proof of farm income for the last three (3) years. <br /> <br /> 4. ~ in describing the use of and/or commodities that will be stored in the proposed structure: <br /> <br /> 5. What is the size of the proposed building? L[NGIH~_ WIDTH ~ HEIGHT I(...~I AREA ~ <br /> 6. ~cture located within a flood plain? Y N ~ <br /> <br /> 7/,/W~e propo/~ed ~ructure have any of the following systems? If yes- separate permits are required. <br />/ ~ Plumbing Y N Heating/Cooling/Ventilation Y N Septic Y N <br /> <br /> 8. Where will restroom facilities be provided? '~¢,~ ~, <br /> <br /> 9. What is the maximum number of people present in the building at any one time during the year? <br /> <br /> 10. Is this structure used by the public at any time? Y N / <br /> Explain <br /> <br />11. What is the distance from the proposed structure to oroperty lines and/or other structures? <br /> Front_~;l~. Rear_~j~ Left side~ Right sidec~:~OOther <br /> <br />12. This application will not be considered complete without a site plan that includes the size of the building. <br /> **See attached site plan requirements. <br /> <br />I certify that I have read this application and state that the information given is correct. I agree to comply with <br /> <br />DATE <br /> <br />PHONE <br /> <br />g to building construction. <br /> <br /> NAME (Please Print) " <br /> <br /> U ' STREET ADDRESS ~' <br /> <br /> CITY STATE/ZIP COD[~ <br /> <br />MC15-76-REV 7/97 FOR OFFICE USE ONLY <br />APPROVED DENIED DATE <br /> <br /> <br />