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ik, Agricultural or Forestry Building Exemption Certification Equine Facility Exemption Certification \\n- Marion County Public Works—Building Inspection Divisio C W r', Marion ri t 5155 Silverton Rd.NE, Salem Oregon 97305 A Phone: (503) 588-5147 Fax: (503) 588-7948 Email: buildingna,co.marion.oritir o 1 2022 ° R' E C ° N MARION COUNTY Site Plan is Required—see attached information BUILDING INSPECTION Owner/applicant name: 5 'J) 44.'0 Phone: )-oe 1?-/-`71 k(s Email: Jere- r.Are Gm1c oust, ,v_1 Mailing address: (tSSb ttm2 Caetc-g City/State: S J n D ti Zip: Job site address: l0 69\--kLe- CrteiC.e.d- City/State: Sc..t eivi, 02 Zip: ai73 (� Parcel Information: Parcel Size: µz, Acre Parcel No.: Zone: Proposed Building Information Describe specific use of the building and items contained within t"'iUnar crow In , C,rep-a,�S C ti��,��grS ''l'At0; )sw Building Data: Length: L(og Width: la- Area: 02,040 Height: :4 l Pc fproe Type of Exemption: Agricultural Building ❑ Forestry Building ❑Equine Facility(Provide information below): What is the proposed maximum number of people(including employees, owners,etc.)that will be present in the building at any one time? S Will this structure be used by the public at any time? ❑Yes 1No Is the proposed structure located within a floodplain? ❑Yes No Is the building located on/used in the operation of a farm? AYes o No Is the proposed structure a residential dwellingor manufactured home? ❑Yes No Is the use of the structure or the items within it used for any business or commercial activities? ❑Yes KNo If yes,please explain: Agricultural/Equine Exemption Criteria—Select all that apply: ❑ Storage,maintenance, or repair of machinery, equipment, and supplies used on this farm 'tit Raising,harvesting, or selling crops raised on this farm ❑ Feeding,breeding,management, or sale of livestock,poultry, furbearing animals, or honeybees ❑Dairying or the sale of dairy products produced on this farm Other agricultural,horticultural, or animal husbandry used ❑ Stabling,training,riding lessons, or clinics(Complete Equine Exemption Criteria) # of stalls/horses #of stalls/horses for personal use only #of stalls/horses used for commercial or trade purposes including boarding,training,rentals, clinics, shows,etc. Which of the following systems will the proposed structure have? Electrical JYes ❑No(Complete Electrical Wiring Criteria) Will there be a concrete slab either within or adjacent to the building? ❑Yes DiNo Will there be farm animals(poultry excluded)within the building at any time? ❑Yes r)(No Will there be farm animals(poultry excluded)on the slab at any time? ❑Yes No Will the building be used for storage of feed,hay, or straw? ❑Yes k No Will the building be used for major repair of motor vehicle equipment? ❑Yes )(No Heating/cooling/ventilation/mechanical Yes ❑No Septic oYes 'No (Any yes answer will require a separate permit) Plumbing(Please specify fixture type) NYes ❑No t-ti,sE au?, Page 1 of 5