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3150 LANCASTER OR NE- SUITE C <br />SALEM OREGON 97305 S03-S88-5147 <br /> <br />APPLICATION FOR EXEMPT STATUS FROM THE STRUCTURAL SPECIALITY CODE <br />FOR AN AGRICULTURAL BUILDING ON A COMMERCIAL FARM <br /> <br />PROPOSED LOCAEION: <br />PROPERTY OWNER: ~ TAX ACCOUNT: <br /> <br /> [J EACRES: <br />I. s,p p )lassified by the Assessor as farm deferred? <br /> <br />TOTAL//OF ACRES FARMED: <br /> <br /> Y/N <br /> <br />2~J~'~ {];[~l~,ithin the U[ban Gr~th Bounda~V~ Y N ~ <br /> INSPECTION · <br /> <br /> ~ SP~IFIC in describing your commercial farm enterprise, size o~ operation, and annual profit. <br /> provide pro~ of [arm income ~or th~ 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 />5. What is the size o{ the proposed buildingJ LENGTH I'Z WIDTH '=/'O' HEIGHT I~' AREA <br />6. Is the p~o~osed stru~ufe I~at~ within a flo~ plain~ Y__ N <br /> <br />7. Will the propos~ stru~ure have any of lee following syst~s? If y~- s~arate p?rmi~ are required. <br /> El~tri~l Y ~ N__ Plumbing Y N ~ Heatin~CooNn~entilation Y N ~ S~tlc Y __ <br /> <br />9. What is the maximum number of people present in the building at any one time during the <br /> <br />10. Is this structure used by the public at any time? Y N V/ <br /> Explain <br /> <br />1 t. What is the distance from the proposed structure to properb/lines and/or other structures? <br /> Front '~)O* Rear ':/'2~ ' Lelt side Z~' Right side~Jl~ Other -. <br /> <br />12. This application will not be considered complete without a'slte plan that includes the size of th~ building. <br /> · 'See attached sile plan requirements. <br /> <br />I certify that I have read this application and state that the information given is correct."l agree to comply wltb <br />all state laws and county ordiqances relating to building construction. <br /> <br />S~h~TURC <br /> <br />DATE <br /> <br />MC1S-76-REV 7/97 <br />A PPI~JVFO <br /> <br /> ,' L. <br />NAME (Please Printl <br /> <br />FOR OFFICE USE ONLY <br /> <br /> <br />