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• <br /> 555-z-5- oo co"ZSq-Pt-gE <br /> Y '' Agricultural or Forestry Building Exemption Certification <br /> Equine Facility Exemption Certification <br /> D D D ��' County Public Works—Building Inspection Division <br /> Marion D Li <br /> 5155SilvertonRd.NESalemOre on97305County ;i' U_ g <br /> f.5 <br /> e "_ _:8-5147 Fax: (503) 588-7948 Email: building�u,co.marion.or.us <br /> o R:.E ,G o N <br /> Site Plan is Required—see attached information <br /> Owner/applicant name: 14truAl 1 Weiid 1 kinj Phone: (5D3) A$I.303(o Email: �JjG 74i ' an— <br /> Mailing address: P 0, 60y 1 ��// City/State:3 t1/Wfin ,Oi2 u v-, Zip: a 73 g 1 <br /> Job site address:4155 enola "File/ N. t E City/State: gc,olt5 AIMS, Vart, Zip: 1'I315 <br /> Parcel Information: Parcel Size: g7.5 QU7par Parcel No.: (1"12,$O(0 ()Og0 I Zone: <br /> Proposed Building Information <br /> Describe specific use of the building and items contained within ' I�''hilE( iligni d h g{ p .O. pmint <br /> l JJ JJ ������ <br /> Building Data: Length: 30' Width: 3(,' Area: I On 5q ff. Height: 20' <br /> Type of Exemption: o Agricultural Building $Forestry Building o 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? 2. <br /> Will this structure be used by the public at any time? oYes XNo <br /> Is the proposed structure located within a floodplain? oYes XXNo <br /> Is the building located on/used in the operation of a farm?*es o No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes X(No <br /> Is the use of the structure or the items within it used for any business or commercial activities? oYes "Q No <br /> If yes,please explain: <br /> Agricultural/Equine Exemption Criteria—Select all that apply: <br /> Storage,maintenance,or repair of machinery, equipment, and supplies used on this farm <br /> o Raising,harvesting, or selling crops raised on this farm <br /> o Feeding,breeding,management,or sale of livestock,poultry,furbearing animals,or honeybees <br /> o Dairying or the sale of dairy products produced on this farm <br /> o 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 oYes XNo(Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building? oYes '1j(No <br /> Will there be farm animals(poultry excluded)within the building at any time? oYes XNo <br /> Will there be farm animals(poultry excluded)on the slab at any time? oYes )(No <br /> Will the building be used for storage of feed,hay, or straw? oYes XNo <br /> Will the building be used for major repair of motor vehicle equipment? oYes XNo <br /> Heating/cooling/ventilation/mechanical oYes j/No <br /> Septic _ oYes XNo (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) oYes )(No <br /> Page 1 of 5 <br />