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555 --ZZ- 006c c/7—'-h <br /> Agricultural or Forestry Building Exemption Certification <br /> ffr• : Equine Facility Exemption Certification <br /> Marion County Public Works—Building Inspection Division <br /> Marion 5155 Silverton Rd.NE, Salem Oregon 97305 <br /> County <br /> Phone: (503) 588-5147 Fax: (503) 588-7948 Email: building@co.marion.or.us <br /> OREGON <br /> Site Plan is Required—see attached information <br /> Owner/applicant name: '\ DeC\ .\mc\A.A Phone: 503-9141"130\ Email: b_ <e_kvranme,yeihcc.r <br /> Mailing address: 750 1174L /WW A1E City/State: Sett 6173 i 7 <br /> Job site address: 750 117 rh Ave. AI/E. City/State: S&LE '� Zip: q 13 i 7 <br /> Parcel Information: Parcel Size: Parcel No.: Zone: <br /> Proposed Building Information <br /> Describe specific use of the building and items contained within <br /> Building Data: Length: SC," Width: %4 ' Area: 7,4ficO Height: (g <br /> Type of Exemption: RrAgricultural Building ❑ Forestry Building ❑ Equine Facility(Provide information below): <br /> What is the proposed maximum number of people(including employees, owners,etc.)that will be present in the building at <br /> any one time? a.. <br /> Will this structure be used by the public at any time? oYes No <br /> Is the proposed structure located within a floodplain? oYes INo <br /> Is the building located on/used in the operation of a farm? dyes ❑No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes iNo <br /> 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 /> Agricultural/Equine Exemption Criteria—Select all that apply: <br /> rXtorage,maintenance, or repair of machinery, equipment, and supplies used on this farm <br /> ❑Raising,harvesting, or selling crops raised on this farm <br /> ❑Feeding,breeding,management, or sale of livestock,poultry, furbearing animals, or honeybees <br /> ❑Dairying or the sale of dairy products produced on this farm <br /> ❑ Other agricultural,horticultural, or animal husbandry used <br /> o Stabling,training,riding lessons, or clinics (Complete Equine Exemption Criteria) <br /> #of stalls/horses <br /> #of stalls/horses for personal use only <br /> #of stalls/horses used for commercial or trade purposes including boarding,training,rentals,clinics, shows, etc. <br /> Which of the following systems will the proposed structure have? <br /> Electrical _ Yes )1 No(Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building? cICTes o No <br /> Will there be farm animals(poultry excluded)within the building at any time? oYes 'No <br /> Will there be farm animals(poultry excluded)on the slab at any time? oYes dNo <br /> Will the building be used for storage of feed,hay, or straw? oYes dNo <br /> Will the building be used for major repair of motor vehicle equipment? oYes E No <br /> Heating/cooling/ventilation/mechanical Yes ,t No <br /> Septic Yes '.No (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) Yes 71.No <br /> Page 1of5 <br />