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h1-0-021136 f E <br /> - ..N Agricultural or Forestry Building Exemption Cert}J•do C <br /> r_ Equine Facility Exemption Certification ✓✓ C, <br /> • Marion County Public Works—Building Inspection Di pion L__. <br /> 1riarsOr? 5155 Silverton Rd.NE, Salem Oregon 97305 MAR 28 2024 <br /> • "Ci ntAl : Phone: (503) 588-5147 Fax: (503)588-7948 Email:building@co.marion.or.us <br /> o W. C N_ MAIIL)N COUNTY <br /> BUILDING INSPECTION <br /> Site Plan is Required—see attached information <br /> Owner/applicant name: —le rola- Skek- e. Phone: 503 5S —gbzv Email: nlc f.h(Xht yhwr't1 <br /> Mailing address: PO ProY 2-6 a._ City/State: .5 ce-t is M.,`IV S De_ zip: nt `l > 7 5 Can <br /> Job site address: r--� City/State:5L r t.} M;di( �' Zip: 1'7 3 7 S <br /> Parcel Information:Parcel Size: 3 7 :L.-(-4 Parcel No.: 0(a I E.35 0/Ott 0 Zone: �= <br /> • Proposed Building Information <br /> Describe specific use of the building and items contained within 7/�7• 5 Tim�j -- `7�►r��y <br /> 4-raciov- r le Me S ;veL CYDA _ s ,re J/vide <br /> Building Data:Lengtli: � , e' Width: 3-or Area: Height / g <br /> Type of Exemption: th.Agricultural Building l i 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? <br /> Will this structure be used by the public at any time? oYes igNo <br /> Is the proposed structure located within a floodplain? oYes c.No <br /> Is the building located on/used in the operation of a farm? oYes o No <br /> Is the proposed structure a residential dwelling or manufactured home? oYes XNo <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 /> VStorage,maintenance,or repair of machinery,equipment,and supplies used on this farm <br /> o Raising,harvesting, or selling crops raised on this farm <br /> • <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 )s(No (Complete Electrical Wiring Criteria) <br /> Will there be a concrete slab either within or adjacent to the building? oYes sNo <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? 'Yes o No <br /> Will the building be used for major repair of motor vehicle equipment? oYes }Zf No <br /> Heating/cooling/ventilation/mechanical oYes %No <br /> Septic oYes 151(No (Any yes answer will require a separate permit) <br /> Plumbing(Please specify fixture type) oYes 1KNo <br /> Page 1 of 5 <br />