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9-cod4 16 -A-C C F' <br /> ; or Forestry Building Exemption Certification _J <br /> = U13 41. <br /> 11!rilisi,pii <br /> aFacilityExmptionCertification JUN 0 5 2019 <br /> Public Works—Building Inspection Division <br /> Marion ilverton Rd.NE, Salem Oregon 97305 MARION COUNTY <br /> CountPhone: (503) 588-5147 Fax: (503) 588-7948 Email: building@a,co.mari :aa <br /> ING INSPECTION <br /> OREGON <br /> Owner/applicant name: Rijk Zwaan USA Phone: 360-202-0665 Fax: 360-336-9216 <br /> Mailing address: 2012 63rd Ave NE City/State: Salem, Oregon Zip: 97305 <br /> Job site address: 2012 63rd Ave NE City: Salem, Oregon Zip: 97305 <br /> Directions to the site: Turn right off Sunnyview rd on to 63 Ave NE, Driveway on left. <br /> Proposed Building Information <br /> 1. Site plan is attached(required): •Yes ❑No <br /> 2. Type of Exemption: •Agricultural Building ❑ 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 • No <br /> If yes,please explain: <br /> 4. Describe use of the building and items contained within: Ag Storage, Field work Implements, Screen Cage Netting, <br /> Sprayer, row cover. <br /> 5. Is the property in farm or forest deferral? •Yes ❑ No <br /> 6. Is the proposed structure located within a floodplain? oYes • No <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 oYes ■No <br /> Septic oYes ■No <br /> Heating/Cooling/Ventilation/Mechanical oYes ■No <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? 2 <br /> 10. Where will restroom facilities be provided? Across the gravel lot in Ag machinery/storage shop <br /> 11. Is the proposed structure a manufactured home? oYes •No <br /> 12. Building Data: Length: 75 feet Width: 40 feet Area: 3000 ft2 Height: 18 foot eave <br /> 13. Parcel Information: Parcel Size: 23.8 ac of 79.63 ac Parcel No.: 072W21A 00100 Primary Zone: AG/Farm <br /> Page 1 of 5 <br />