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MARION COUNTY <br /> BUILDING INSPECTION <br />Commulftty Development Center · 285 Church St. NE · Room 132 · Salem, O~on 97301 <br />Office Hour~: 8:00 - 4:30 Phone $8~-5147 24 Hour Code-A-Phone: 588-7904 <br /> <br />4o <br /> <br /> APPLICATION FOR EXEMPT STATUS <br /> FROM THE STRUCTU~ff., SPECIALTY CODE <br /> FOR AN AORICULTURAL BUILDING ON A CO~4~RCIAL FARM <br /> <br />PNO ORED LDCA ION, <br /> <br /> SECTION: ,,5'"i(~ 'I'~SlIIP: ~.,5' RM~OE: <br />Is this property classified as farm deferred? r ~'~ N <br />(You must provide a computer printout verifying special <br /> <br />ACCOUNT, <br />AeR.ES: ~. q <br /> <br />This can be obtained at the Marion County Assessor's office located in the Franklin <br />Building, 495 State Street, Salem) <br /> <br />Are you located within the Urban Growth Boundary? Y __ N / <br />Describe in detail your commercial farm enterprise: ~~(~eJ~6f- ~f <br /> <br />Describe in detail the use of and/or commodities stored in the proposed structure: <br /> <br />Is the proposed structure located within a flood plain? Y N / <br /> <br />Does the propos~ structure have any of the following systems? <br />Electrical Y ~/ N Plumbing Y N Heating/Cooling/Ventilation Y N <br /> <br />Where will restroom facilities be provided? ~'~/~9~/~(~ ~ <br /> ! <br />Will persons be working in the structure more than a total of 144 hours, during any <br />week of the year? Y __ N ~ <br />Is this structure used by the public at any time? Y__ N ~ <br />Explain: <br /> <br />10. <br /> <br />11. <br /> <br />What is the distance from the proposed structure to property lines and/or other <br />structures? Front ~0t Rear ~/~r t ~I <br /> Left Side--~--~' Right Side /~0 Other structures <br /> <br />This application will not be considered complete without a site plan. See attached <br />site plan requirements. <br /> <br />I certify that I have read this application and state that the information given is <br />correct. ~egree to c~mply with all state laws and county ordinances relating to building <br /> <br /> SIG4~/3~Pb''~t'--' // NKM~ (Plea~L9 print)_. <br /> ST~ET ~D~SS <br /> <br /> PHONE CITY STATE ZiP <br /> <br />PL~IqlNO DIVISION: <br /> Validated By: ~ Approved: <br /> <br />BUILDING DIVISION: <br /> Validated By: ~ Approved: <br /> <br />Denied: <br />Denied: <br /> <br />COMMENTS: <br /> <br />APPROVED: I~ <br /> <br /> DENIED: ~ STRUCTURAL PERMIT IS REQUIRED <br /> Other permits required:~rlca5 pl-mhing, Mechanical, Septic <br />MC 15-76 <br />REV 8/94 <br /> <br /> <br />