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MARION COUNTY ,, . .' <br /> <br /> ,,, t, ~/. <br /> <br />Is thi~ ~roper~y classified as farm de~erred? Y~ N <br />(~ou must provide a computer printout verifying special assessment for farm use. <br />This can be obtained at the Marion County Ass~mor's Office located in the Prankl~n <br />Building, 495 state Street, Salem) <br /> <br />Ar~ you ~oca~ed within th~ urban ~row~h Boundary? Y N <br />Dosori~e in de, ail your celestial farm enterprise~ <br /> <br />Describe in detail the_.pse of and/or commodities stored in the proposed structure: <br /> <br />Is the proposed structure located within a flood plain? Y __ N ~/O <br /> <br />Does the proposed structure have any of the followin9 systems? <br />Electrical Y N ~/~ Plumbing Y ,: N~. Heating/Cooling/Ventilation <br /> <br />Where will restroom facilities be provided? ~ <br />Will persons be working in the structure more than a total of 144 hours, <br />week of the year? Y __ N ~ <br /> <br />IS this str~c~ure used by the public at any time? Y N ~O <br />Explain: <br /> <br />during any <br /> <br />10. What is the distance fr'Qm t e <br /> DD~_ proposedRear ~structure to property lines and/or o~hes <br /> Front <br /> Left Side '__7~ Right Side 75 # Other structures <br />11. This application will not be considered complete without a site plan. See a~tached <br /> site plan requirements. <br /> <br />I certify that I have read this application land state that the informatiom given is <br />correct. I agree to comply with all state laws and county ordinances relating to building <br />construction. <br /> <br /> ~ON~ <br /> <br />OFFZ~ U$~ ONLY SITUS NO. <br />PI.~,NNING DIVISION: <br /> Validated By:~ Approved: <br /> <br />N~(PleaseRrint) ~ <br /> <br />CITY SPATE ZIP <br /> <br /> BUILDING DIVISION; <br /> By: ~ Approved: Denied: ~ Date: <br /> Validated <br /> <br /> Other pemits required; Electrical, pl,,mhin9, Mechanical, Septic <br /> <br />MC 15-76 <br />REV 8/94 <br /> <br /> <br />