|
Prii .
<br /> ii ,„_,,,,, _ ,
<br /> , ,.. ,,.., �� Lural or Fores Buildin. Exem I tion Certificati,�� E,
<br /> ._ >. ; , Equine Facility Exemption Certification (�
<br /> ,1� 1 1 d , Ii, ,t,• ounty Public Works—Building Inspection Division.! ` voR 1 3 201'10
<br /> 0
<br /> Marion P 5155 Silverton Rd.NE,Salem Oregon 97305
<br /> County :, ��
<br /> Phone: (503)588-5147 Fax: (503) 588-7948 Email:building@,co.marion.�y,u.�,-,;3N GCS
<br /> OREGON 4�.1lt_fJiNGi
<br /> Owner/applicant name:S "t.Av\y& Gaff) Phone: .. 3—�{ r rlFax: N I'ECTION
<br /> Mailing address: 7o- i S 11er a v 1 , City/State: ALMS V; Ile/OlK Zip: R73d S
<br /> Job site address: .Sa_c,.Ne_ a— 0--by U-C.., City: Zip:
<br /> Directions to the site: Vvo ce.e 1 C aSk 01A f{u aa-, .'yak- S e-0 1 ±"v ftfi IA ct o lie r
<br /> 44331 lirerracS) +uv+n 1eft dv Sic1-��,,,w. R��d- `t'�ev‘r:r t^ ov\ S1nerw,o‘v. v4, c rp)1 g w‘:t^e S
<br /> Propos�d Building Information `Tip
<br /> 1. Site plan is attached(required): oYes o No
<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? oYes ,p(No
<br /> • If yes,please explain:
<br /> 4. Describe use of the building and items contained within: St v..��h�•e eZt SAD e, Ca--v\d
<br /> LOON'•
<br /> -
<br /> le stro r ((//
<br /> 5. Is the property in farm or forest deferral? 'Yes o No
<br /> 6. Is the proposed structure located within a floodplain? oYes JlrNo .
<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 ` es o No ,,‘A /l j./.5-
<br /> .
<br /> Septic oYes XNo l
<br /> „..4
<br /> Heating/Cooling/Ventilation/Mechanical }(Yes o No _
<br /> 8. Will this structure be used by the public at any time? oYes teNo
<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? .2 -9 .
<br /> 10. Where will restroom facilities be provided? "X kQ L4--C C-
<br /> 11. Is the proposed structure a manufactured home? oYes .xieNo `' ��J /,
<br /> 12. Building Data:Length: 40 - i:,-t- Width: 3o f cir ea: /o2Jvo Pi ' Height: `�c let e 1Z 0
<br /> 13. Parcel Information:Parcel Size: 1(�,S.g' Parcel No.: 2?-rafoi-- Zone:
<br /> ciC v-e s
<br /> Page 1 of 5
<br />
|