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/9-60/M/46--C <br /> ' 4.0 •,,� Agricultural or Forestry Building Exemption Certification <br /> Equine Facility Exemption Certification <br /> Marion County Public Works-Building Inspection Division <br /> Mari 5155 Silverton Rd.NE, Salem Oregon 97305 D [� D <br /> Phone: (503) 588-5147 Fax: (503) 588-7948 Email:building(a�co.ma Q I`' <br /> OREGON �/ L" <br /> Owner/applicant name: £ UAc-�:e K- -e+.`z.; Phone: 742.7- 4 Cis- Fax: <br /> S <br /> Mailing address: 1 L/ c (-4x(dPo Oil& f{25�City/State: gtt*k,f7 02 Zip: q,3 1:3 S <br /> Job site address: Pi 3 L ic) (-)(Ls ! (Z se,-- City: S1--Mi)I ow__ Zip: ll7 o c <br /> Directions to the site: (44S C¢�Q.Q1-fr_.„.4 <br /> S � Squ-r--f--..•, f.,-)c2(zi, (- ((s F.--z4- r4_ L -Jt i12, <br /> oposed Building Information <el :S <br /> 1. Site plan is attached(required): Oes ❑No <br /> 2. Type of Exemption: Agricultural Building o Forestry Building equine Facility(provide information below): <br /> e" Total number of stalls or equivalent number of horses: -ct <br /> ¢f 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 /No <br /> If yes,please explain: <br /> 4. Describe use of thee building and items contained within: 3 lac5_ ye, 1-e_ (ct.j � iz.JS <br /> CR Vii( <br /> 5. Is the property in farm or forest deferral?AYes ❑No <br /> 6. Is the proposed structure located within a floodplain? oYes 6lo <br /> 7. Will the proposed structure have any of the following systems?(If yes, separate permits are required for each system): <br /> Plumbing oYes o No If plumbing will be installed,what type of fixture(s)? <br /> Electrical es ❑No . pt#4 l4,— ___ <br /> Septic oYes o No ?, / <br /> Heating/Cooling/Ventilation/Mechanical oYes o No i <br /> 8. Will this structure be used by the public at any time? oYes /No <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? II <br /> 10. Where will restroom facilities be provided? v.S-e-- <br /> 11. Is the proposed structure a manufactured home? ❑Yes /Io <br /> 12. Building Data: Length: Ila Width: 36 Area: 174'1'3 Height: /y <br /> 13. Parcel Information: Parcel Size: ,)-t, : 9 Parcel No.: Zone: <br /> Page 1 of 5 <br />