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BUILDING INSPECTION <br /> <br /> APPLICATION FOR EXEMPT STATUS FRO/S'~T,b~I~JU.}~'~i~J~ECIALITY CODE <br /> FOR AN A~RICULTU~L <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 />QBE SPECIFIC in describing your commercial farm enterprise, <br /> proof of farm income for the last three (3) years. <br /> <br />size of operation, and annual profit. Provide <br /> <br />?E 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 Y-.. Septic Y N_~ <br /> <br />8. Where will restroom facilities be provided? <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__ Rear Left side 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 sta~e laws and county ordinances relating to building construction. <br /> <br /> SIGNATURE NAME (Please Print) <br /> <br />PHONE <br /> MC15-76-REV 4/99 <br /> APPROVED <br /> <br /> STREET ADDRESS <br /> <br />FOR OFFICE USE ONLY <br />DENIED <br /> <br />S'i'ATE/ZIP CODE - <br />DATE <br /> <br /> <br />