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• <br /> y—O C.5" 6E <br /> Agricultural or Forestry Building Exemption Certification <br /> Equine Facility Exemption Certification <br /> Marion County Public Works—Building Inspection Division <br /> Marion 5155 Silverton Rd.NE, Salem Oregon 97305 <br /> County . <br /> r Phone: (503) 588-5147 Fax: (503) 588-7948 Email: building@co.marion.or.us <br /> o ' ;.=Ecosv. "6Crl <br /> Site Plan is Required—see attached information v` Lfl5 <br /> Owner/applicant name: \ L L £L Phone: mail: <br /> Mailing address: -4,69 n N 15P h.) H RP S City/State: 7—PPS PS Or) c fl Zip: G 0 3 5 a <br /> Job site address: 1 n)) 1 (LL K1 ��� City/State: Je..,Re 4 ) O R Zip: ciq 3 a <br /> Parcel Information: Parcel Size: Parcel No.: Zone: <br /> Proposed Building Information <br /> Describe specific use of the building and items contained within C� Cad sz,ft A CO`A 0 1 1 n r occ <br /> Length: ic1' 3��� Height:Building <br /> Data: Width: Area: Hei t: <br /> Type of Exemption: o Agricultural Building o Forestry Building 14 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? �. <br /> Will this structure be used by the public at any time?--oYes 11,No — <br /> Is the proposed structure located within a floodplain? oYes 'No APPROVED <br /> Is the building located on/used in the operation of a farm? BYes ❑No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes No <br /> Is the use of the structure or the items within it used for any business or commercial activities? oYes kNo <br /> If yes,please explain: <br /> Agricultural/Equine Exemption Criteria—Select all that apply: <br /> o 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 /> $p 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 No(Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building? oYes at <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 EINo <br /> Will the building be used for storage of feed,hay, or straw? oYes ' .No <br /> Will the building be used for major repair of motor vehicle equipment? oYes TOANo <br /> Heating/cooling/ventilation/mechanical oYes ` No <br /> Septic oYes 'allo (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) oYes q;jlo <br /> Page 1 of 7 <br />