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10:11 FAX 1 ~03 988 71148 M~RION B G $ <br />3~o ~N~TEK D~ NE - SUITE C <br /> <br />(~002 <br /> <br />APPLICATION FOR EXEMPT STATUS {:KO/V{ THI <br /> FOR AN AGRICULTURAL BUILDING O <br /> <br />COMMERCIAL FAPJ~t <br /> <br /> . ., <br /> <br /> BUILDING SITE ACR~: ..... I ~ . TOT~RES FARMED, ~ .-- <br /> <br />3- ~ M d~ctibing ~u~ commercial farm enk~ti~, t{~ gf ~p~mrion, ~d annual p~fit.~ <br /> p~i~proofof~rmincomg~oG~a~t~r~(3)y~rs. ~ ~ ~ aa ~ <br /> <br />4. ~E, . .. d~cr[b~n, ,he of and/or comm~i,~s ~Hac ,{il be ~or~ ,n thc <br /> <br /> S. ~at i~ the ~i~c of thc proposed building? L~NGTH ~ WI6TH ~ H~IGHT /~I AREA <br /> <br /> 6. ~ ~e pmpo~ structure Io~t~ within a flood ptain} J ~ <br /> 7. Will the prop~d s~ ha~ any of the fol~Jn~ s~ms~ ~ T~ ~ra~ ~rml~ ar~ ~uircd. <br /> E ~r c~ Y N ~ Plamb/n~ Y N ~ Heatin~li~efl~la~on Y N ¢~et}¢ V ~ N <br /> <br /> 9, ~at {s ~ maximum number of ~lu present in ~e buJld{~ ~t any one time du~in{ ~e ye~l <br /> 10. Is thi~ sU~ture us~ ~ the public at any dme~ Y N J~ <br /> <br /> 11, Wha~ i~ ~ distance ffo~ the propo~ s~u~um iD pmp¢~ lin ~ an~ <br /> Front~ ~ Rear ....... Lek sid~ Rl~t si~ <br /> Othe~ <br /> - <br /> This a~licet{on wdl not ~ con~d~d ~m~e~ wn~out a s~tf alan t~t {nclud~ the size o{ the buddmg. <br /> "See a[/&ched site plan requ~r~enb. <br /> I ced{~ fl~at I have ma~ thi~ ~Ellcation ~nd s~te ~1 ~e in,rs?ion gi~n is cor~t- I ague to comply with <br /> ail s~w, an~ or~ ~launs to buildms <br /> <br /> _PHONE . . ~IY j '~ ,, S3ATE~IP CODE , <br /> ~C15-76-~[V 7~7 FOR OFFI~ US~ ~NLY <br /> AFP~OVED DENIED ~ DATE~ <br /> ' I.....C_: <br /> <br /> <br />