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BUILDING INSPECTION ~r.~llrJ ~ r.,,u <br /> 3 50 b',NCASTER DR NE- SUITE C <br />-- SALEM OREGON 97305 503'588-5147 FEB t~ 1l~9~1 <br /> MARION OOUNTY <br /> APPLICATION FOR EXEMPT STATUS FROM THE STRUCTURAL SPEC,~IIIMI~N~INIPP~ION <br /> FOR AN AGRICULTURAL BUILDING ON A COMMERCIAL FARM <br /> <br />PROPOSED LOCATION: <br /> <br />PROPERTY OWNER: <br /> <br />BUILDING SITE ACRES: <br /> <br />TOTAL# OF ACRES FARMED: <br /> <br />1. Is this property classified by the Assessor as farm deferred? <br />2. Are you located within the Urban Growth Boundary? <br /> <br />Y-X- N <br />Y NX <br /> <br />3. BE SPECIFIC in describing your commercial farm enterprise, size of operation, and annual profit. If applicable, <br /> provide proof of farm income for the last three (3) years. <br /> <br />4. BE SPECIFIC in describing the use of and/or commodities that will be stored in the proposed structure: <br /> <br />6. Is the proposed structure located within a flood plain? Y __ N <br /> <br />7. Will the proposed structure have any of the following systems? If yes- separate permits are required. <br /> Electrical Y ~ N Plumbing Y~_ N Heating/Cooling/Ventilation Y N ~ Septic Y N X <br />8. Where will restroom facilities be provided? _/-N ~-~(~5'T-~'~ l~l.~,~.u ~'7~¢.~ ~(or~ <br /> <br />9. What is the maximum number of people present in the building at any one time during the year? <br /> <br />10. Is this structure used by the public at any time? Y N ~ <br /> Explain <br /> <br />11. What is the distance from the proposed structure to property lines and/or other structures? <br /> Front ,'~O Rear~r00 Left side/~0 -~ Right side/~'~'"/'Other <br /> <br />12. This application will not be considered complete without a site plan that includes the size of the building. <br /> '*See attached site plan requirements. <br /> <br /> I certify that I have read this application and state that the information given is correct.' I agree to comply with <br /> all straws and count~:2l:ing to building construction. <br /> <br />//~NATURE · -- NAZi5 (Ple~ase Print) '~'~m~ <br /> PHONE <br /> <br />CITY STATE/ZIP CODE <br /> <br />MC1S-76-REV 7/97 FOR OFFICE USE ONLY <br />APPROVED DENIED DATE <br /> <br /> <br />