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<br /> 4 3 -06 7 493-,q -
<br /> ." «,yw Agricultural or Forestry Building Exemption Certification m rE
<br /> Equine Facility Exemption Certificationl `© it il V
<br /> • Marion County Public Works—Building Inspection Di ' n
<br /> , Marion 5155 Silverton Rd.NE, Salem Oregon 97305
<br /> County • 12023
<br /> Phone: (503) 588-5147 Fax: (503) 588-7948 Email:building(a� . no�.re u�
<br /> OREGON
<br /> MARION COUNTY
<br /> Site Plan is Required—see attached information BUILDING INSPECTION
<br /> Owner/applicant name: RU SS KE,.W Phone: , 03 s37 j457 Email: !'Oss jcn[(Pflder,
<br /> Mailing address: lO 29'7__ Li6c -1y RA .$ City/State: S A(-I M Zip: /7_306 C.c.n
<br /> Job site address: S RaIL City/State: S,4L A4 Zip: /T 7.3C7/4.
<br /> Parcel Information: Parcel Size: 4,3 (C Parcel No.:013 ylf Of A 13 Oo Zone:
<br /> Proposed Building Information
<br /> Describe specific use of the building and items contained within i.-q r i cal f'fU or L Ilui ki I NG Needok
<br /> -1-0 s-k Ply Fsrl . Pcdd A' .'mcic g-s4 I i`u F in24 Is ,- P[vs Anl,'ra I ct
<br /> Building Data: Length: 6j Width: IPA bO" Area: _,--i,_3C Height: M.
<br /> Type of Exemption: Agricultural Building o Forestry Building ❑ Equ - Facility information below):
<br /> What is the proposed maximum number of people(including employees,ow. ,etc.)that will be present in the building at
<br /> any one time?
<br /> ti
<br /> Will this structure be used by the public at any time? oYes xi No
<br /> Is the proposed structure located within a floodplain? oYes ,
<br /> Is the building located on/used in the operation of a farm? li , . No
<br /> Is the proposed structure a residential dwelling or manufa . -, .ome? ❑"_,, No
<br /> Is the use of the structure or the items within it}fed for .. ' ,.i siness o commercial activities?1Yes n-
<br /> Ifyes,pleaseexplain: Te ,/My, • , S-fsil ir`_ q,M�n (S, Aft;IInq-!.-�}K
<br /> Agricul •, uine E ption Criteria—Select all that apply:
<br /> I .
<br /> XStorage,maintenance,or repair of ii chinery, \.ment, and supplies used on this farm
<br /> KRaising,harvesting,or s-lling crop .sed on this farm
<br /> (Feeding,breeding, . ... ,ment, or sa. .f livestock,poultry,furbearing animals, or honeybees
<br /> o Dairyin• •.. he sal: 1 produc produced on this farm
<br /> o 0 • r agricul', -..1, . , cultural, . animal husbandry used
<br /> . •ling,traini q: rill', ..-_ •.. , or clinics (Complete Equine Exemption Criteria)
<br /> ,f stalls/h r'.ses 4
<br /> #: ails . ses for personal use only
<br /> #of s`. , , .rses 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 ` No(Complete Electrical Wiring Criteria)
<br /> Will there be a concrete slab either within or adjacent to the building? oYes Di1 No
<br /> Will there be farm animals(poultry excluded) within the building at any time? Yes o No
<br /> Will there be farm animals(poultry excluded) on the slab at any time? oYes x No
<br /> Will the building be used for storage of feed,hay, or straw? ).fiYes o No
<br /> Will the building be used for major repair of motor vehicle equipment? oYes X No
<br /> Heating/cooling/ventilation/mechanical oYes N No
<br /> Septic oYes X No (Any yes answer will require a separate permit)
<br /> Plumbing(Please specify fixture type) oYes list No
<br /> Page 1 of 5
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