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.. ................ <br />AMRo -1 -005 s-4( E <br /> '. 2!;, Agricultural or Forestry Building Exemption Certification <br /> • Equine Facility Exemption Certification <br /> --. Marion County Public Works-Building Inspection Division <br /> Marron 5155 Silverton Rd.NE, Salem Oregon 97305 <br /> County <br /> Phone: (503) 588-5147 Fax: (503) 588-7948 Email:building@co.m <br /> ria - wv <br /> Site Plan is Required-see attached information 1f 8 <br /> Owner/applicant name: Iq I =V pt ) rrvi4;�" 4`E Phone:5a3-`I` � 1 Email: 0I b1e' (atJt f9 Ir4ettoolect <br /> Mailing address: C')3,..t Kt tall 46— City/State: 6 -.2✓As-0 ?- Zip: 9/7d 2-4 <br /> Job site address: ‘173.> eFEA C 4.117 City/State: L z. IZ-'42 0 R Zip: 9"la?Jo <br /> Parcel Information: Parcel Size: Parcel No.: Zone: <br /> Proposed Building Information <br /> Describe specific use of the buildingand items contained within LoW bc, r►'. akG <br /> P � u <br /> Building Data: Length: d Width: L/v Area: /4/So Height: /en <br /> Type of Exemption: XAgricultural Building o 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? I <br /> Will this structure be used by-the public at any time?--oYes - No - - - <br /> Is the proposed structure located within a floodplain? oYes )No <br /> Is the building located on/used in the operation of a farm? Tj 'es o 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 )No <br /> If yes,please explain: <br /> Agricultural/Equine Exemption Criteria-Select all that apply: <br /> R Storage;maintenance, or repair of machinery, equipment, and supplies used on this farm <br /> kRaising,harvesting, or selling crops raised on this farm <br /> EC <br /> peeding,breeding,management, or sale of livestock,poultry,furbearing animals,or ho eesiUL 6 202k <br /> o Dairying or the sale of dairy products produced on this farm <br /> o Other agricultural,horticultural, or animal husbandry used MARION COUNTY <br /> o Stabling,training,riding lessons, or clinics (Complete Equine Exemption Criteria) BUILDING INSPECTION <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 5LNo (Complete Electrical Wiring Criteria) <br /> Will there be-a concrete slab either within or'adjacent to the building? Wes o 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? Yes o No <br /> Will the building be used for storage of feed,hay, or straw?'Yes o No <br /> Will the building be used for major repair of motor vehicle equipment? oYes *To <br /> Heating/cooling/ventilation/mechanical oYes 'No <br /> Septic oYes LNo (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) oYes lvo <br /> Page 1 of 5 <br />