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For County Use Only Planning Department Confirmation of Current Zone District: Print Full Name PARK COUNTY APPLICATION FOR MAJOR SUBDIVISION FINAL PLAT NON-REFUNDABLE APPLICATION FEE: $1600 + $50 PER LOT OR RESERVED AREA All applicants must submit one complete application and attend a pre-application conference with the Park County Planning Department Staff seven to ten (10) working days prior to the application submittal deadline. Following the acceptance of the complete application the applicant must submit thirty (30) collated paper copies or electronic media as requested to the Park County Planning Department on or before the application submittal date. If you have questions regarding this form please contact the Planning Department by phone at (719) 836-4292 or e-mail [EMAIL REDACTED], fax (719) 836-4351, or write to us at P.O. Box 1598 Fairplay, CO 80440. A. APPLICANT AND OWNERSHIP INFORMATION Applicant’s Name: Mailing Address: City: Telephone Owner’s Mailing Telephone B. PROPERTY INFORMATION Complete Legal Description of Property Proposed for the Major Subdivision Final Plat (attach additional page, if necessary): Street Address of Property: Property’s Total Acreage: Current Zone District of Property: ---PAGE BREAK--- Page 2 of 10 Major Subdivision Final Plat – Revised October 2025 Requirements for a Major Subdivision Final Plat Article VI, Division 4, Section 6-405 C. APPLICATION REQUIREMENTS 1. Application Fee. An application fee in the amount of $1600 + $50.00 per lot or RESERVED AREA must be paid at the time of submission of the application. Make the check or money order payable to the Park County Planning Department. The fee pays for the typical cost to the County to process the application. Any additional costs that may occur are the applicant’s responsibility. 2. Tax receipt showing payment of current taxes for the property proposed for subdivision. This can be obtained at the Park County Treasurer’s office. 3. A properly executed Agreement for Payment of Development Review Expenses in the attached form. The Development Review Expense Deposit for a Major Subdivision Final Plat is $750. Make the check or money order to the Park County Planning Department. 4. Evidence of ownership and Encumbrances as defined in Article IV of the Land Use Regulations. 5. A legal description for the property proposed for subdivision prepared by a licensed registered Colorado land surveyor. 6. A signed and notarized certification from the Applicant that proper notice has been provided to the mineral estate owner pursuant to and in accordance with C.R.S. § 24- 65.5-103, or a certification that such notice is not required because the surface estate has not been separated from the mineral estate for the property described in the application. A form of certification is provided in Appendix B (attached). 7. A list of names and mailing addresses of all adjacent property owners to the property proposed for subdivision, (this information is at the Park County Assessor’s Office). 8. A Major Subdivision Final Plat, shall be drafted at a commonly used engineering scale by the use of permanent ink on a stable reproducible drafting medium with outer dimensions of twenty-four by thirty-six inches (24” x 36”). Maps of two or more sheets shall be referenced to an index map placed on the first sheet. Where required data cannot be clearly shown on one plan sheet, additional plan sheets of the same size with easily identifiable match lines may be used. The Final Plat must also be submitted in a digital format that will allow the Mapping Department to accurately reference it into the County’s geographic information system. At a minimum, the Final Plat shall contain: a. A title that prominently identifies the proposed name of the subdivision together with the phrase “Final Plat”. If the property described in the Final Plat is zoned as For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 3 of 10 Major Subdivision Final Plat – Revised October 2025 Planned Unit Development (PUD), the title shall include the phrase “Planned Unit Development”; b. Date of preparation, map scale, and north arrow; c. Name, address and telephone number of the Applicant, land owner(s), planner, engineer, and surveyor; d. A general vicinity map illustrating the location of the property proposed for subdivision, e. Total acreage and surveyed description of the area. No Final Plat showing plus or minus dimensions will be approved; f. Primary boundary survey control points with monument descriptions; all parcel and right-of-way lines dimensioned with curve data including chord and bearings; basis of bearings and relation to true meridian. The data shall be sufficiently complete to determine independently closures for rights-of- way, easements, boundaries, lots, outlots, and blocks. All required boundary monuments shall be placed in the field before the Final Plat is recorded; g. Name and right-of-way width of each road. Right–of-way widths are to be shown at each leg of an intersection, at points of curvature and tangency, at dead- ends, and at angle points; h. Locations, dimensions, and purposes of all easements; i. Number or letter to identify each Lot, Block, and Outlot. Lots and Blocks shall be numbered; Outlots shall be lettered in alphabetical order. The plat shall include sufficient information to designate and restrict the use of any Outlot to the Outlot’s intended purpose; j. An identification of the rights-of-way, easements, parks, open space, and any other public facilities shown on the plat to be dedicated to public use upon the approval of the Final Plat. No areas within the plat may be designated as areas of conditional, planned, or future public acquisition “to be dedicated” or “reserved for dedication”). Dedications of public property not made on the Final Plat shall be made only by General Warranty Deed recorded contemporaneously with the Final Plat unless otherwise approved by the Board of County Commissioners; k. Names of all adjoining subdivisions with dotted lines of abutting lots. If the adjoining land is unplatted, it should be shown as such with the owners’ names; l. Signature and seal of the licensed land surveyor; m. A delineation of the extent of the one hundred (100) year flood plain and any wetlands, if applicable; n. Approval certification and plat language Forms A-1, A-2, A-3, A-4, A-5 and A-6 as identified in Appendix A of these Land Use Regulations. The language will be provided by the County Attorney subject to the approval of the Board of County Commissioners. For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 4 of 10 Major Subdivision Final Plat – Revised October 2025 9. A copy of any agreements, conveyances, restrictions, or private covenants that currently govern, or are proposed for recordation to govern, the use and maintenance of the subdivision and any common private open space or private subdivision amenity. 10. Only where Public Improvements are proposed to serve the subdivision, the Applicant shall also submit final engineering plans, construction drawings, and specifications for all public improvements in a form sufficient to commence construction of the Public Improvements following approval of the Final Plat. 11. A written description of arrangements for providing financial guarantees and sureties for the timely completion of all public improvements. For example, a letter of commitment from a financial institution to issue an irrevocable letter of credit upon approval of the Final Plat. 12. A preliminary or draft Subdivision Improvements Agreement (SIA) in the general form provided by Appendix J of these Subdivision Regulations. In order to ensure timely processing of the application, Applicants must submit a draft form of SIA to the County Attorney for review and revision prior to submitting the application for Final Plat. The Board of County Commissioners shall revise the SIA into a form capable of finalizing upon the conclusion of the public hearing and approval or conditional approval of the Final Plat. 13. Final versions of the studies and reports submitted with the Preliminary Plan shall be prepared by a qualified professional at the Applicant’s cost and submitted with the application. At a minimum, each report shall address the existing conditions, proposed changes of the subdivision, and evaluate risks and challenges presented by the subdivision together with recommendations for mitigation measures to address any identified risks and challenges presented by the proposed subdivision. At the Planning Director or designee’s discretion, some or all of the reports provided for the Preliminary Plat may be used again. 14. Applicants are strongly encouraged to submit with the application additional documentation and information sufficient to demonstrate that the proposed subdivision will satisfy the standards for approval contained in Section 6-406. 15. The Planning Director, Planning Commission and/or Board of County commissioners may require the Applicant’s submission or other studies and reports prepared by a qualified professional at the Applicant’s cost to address issues not covered by the above requirements. Any decision of the Planning Director pursuant to this paragraph may be appealed to the Board of County Commissioners in accordance with Article III, Division 2 of these Land Use Regulations. For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 5 of 10 Major Subdivision Final Plat – Revised October 2025 Note: Refer to Park County Land Use Regulations Article VI Standards for Approval of a Major Subdivision). D. APPLICANT AND LANDOWNER SIGNATURES: The undersigned applicant and landowner hereby verify and affirm that the information contained in this application is complete and accurate. The undersigned applicant and landowner understands and acknowledges that the submission of inaccurate and incorrect information may result in the denial or rejection of the application and/or result in the invalidation of any approvals issued by Park County, Colorado. Applicant: Signed: Print name: If company, state Title/Position: E. VERIFICATION OF DATE OF DELIVERY OF APPLICATION This application was submitted to the Park County Planning Department on the following date and time: Month Day Year Payment of the Applicant Fee was made by: Personal Check Amount $ Cash Amount $ Amount $ Payment of the Development Review Expense Deposit was made by: Personal Check Amount $ Cash Amount $ Amount $ APPLICANT MUST ATTEND THE HEARING. IF A REPRESENTATIVE ATTENDS THE HEARING ON BEHALF OF THE APPLICANT, A NOTARIZED LETTER OF CONSENT MUST ACCOMPANY THE APPLICATION. ALL PLANNING COMMISSION HEARINGS WILL BE SCHEDULED FOR THE SECOND WEDNESDAY OF EVERY MONTH. IF A QUORUM IS NOT AVAILABLE, THE HEARING WILL BE SCHEDULED THE NEXT AVAILABLE DATE. APPENDIX A For County Use Only: Verification of Date of Delivery and County Receipt of Application Print ---PAGE BREAK--- Page 6 of 10 Major Subdivision Final Plat – Revised October 2025 FORM A-1: LEGAL DESCRIPTION AND CERTIFICATE OF OWNERSHIP LEGAL DESCRIPTION: (“Owner/s”) being the owner(s) of the real property of acres located in Park County, Colorado, descried as follows: [Insert surveyed property description of entire bounds of area being platted] [If applicable, insert the following:] DEDICATION: KNOW ALL MEN BY THESE PRESENTS THAT THE Owner(s) of the land described above have caused the land to be laid out and platted under the name of And do herby dedicate, grant, and convey to the public forever and in fee simple all streets, alleys, roadways, thoroughfares, fire lanes, utility and drainage easements, park land, and open space as indicated or illustrated on this plat in compliance with the Park County Land Use Regulations and the landowners shall bear all expense involved in planning, design, and construction of all public improvements except to the extent expressly stated in any County-approved and recorded Subdivision Improvement Agreement. Dedication shall be final upon adoption of a resolution by the Board of County Commissioners accepting the property dedicated by this plat. Except as otherwise stated on this plat, there shall be no limitation or restriction upon the purpose or public use of property dedicated by this plat. [Where applicable] Those areas designated as “outlots” are herby excluded from any development and are reserved for potential or possible future subdivision except as may be expressly stated in a County-approved subdivision improvements agreement. Any future use and development of any outlot shall require further subdivision and County-approval in accordance with the Park County Subdivision Regulations. In Witness Whereof, we do hereunto set our hands and seals this ____day of [Printed Name of Owner] [Printed Name of Owner] (If by corporation, president signs, secretary attests and corporate seal is affixed) STATE OF ) ss. COUNTY OF Acknowledged before me this day of 20__, Notary Public Witness my hand and official seal. My Commission Expires: ---PAGE BREAK--- Page 7 of 10 Major Subdivision Final Plat – Revised October 2025 FORM A-2: SURVEYOR’S CERTIFICATE. SURVEYOR’S CERTIFICATE: I hereby certify that the survey and plat of the real property shown and described hereon were made by me or under my direct responsibility, supervision, and checking, in strict compliance with Colorado statutes, and that both survey and plat are true, accurate and complete. [Insert if applicable statement by the land surveyor explaining how bearings were determined] [Insert if applicable statement by the land surveyor indicating the type of monuments used.] [Insert any required statement by the land surveyor certifying compliance with applicable provisions of the Colorado Revised Statutes] Colorado License No. Registered Land Surveyor Date: FORM A-3: APPROVAL FORM FOR BOARD OF COUNTY COMMISSIONERS APPROVAL BY BOARD OF COUNTY COMMISSIONERS: APPROVED as a Major Subdivision Final Plat by the Park County Board of County Commissioners, this ____day of 20__ subject to all applicable provisions of the 2009 Park county Land Use Regulations, as amended. [If applicable, insert the following:] Subject to the provision that the County shall not undertake the maintenance of dedicated public streets, roads, and thoroughfares until satisfactory construction thereof by the subdivider. Said public streets, roads, and thoroughfares will be accepted by resolution at a regular County Commissioners meeting after completion, inspection, by Park County, and certification of construction in accordance with County standards. BOCC Chairperson Park County Clerk and Recorder FORM A-4: RECORDER’S CERTIFICATE RECORDER’S CERTIFICATE: This plat was filed for record in the office of the County Clerk and Recorder of Park County, on the day of 20__, and duly filed at Reception Park County Clerk and Recorder ---PAGE BREAK--- Page 8 of 10 Major Subdivision Final Plat – Revised October 2025 FORM A-5: TITLE COMPANY CERTIFICATE OF OWNERSHIP TITLE CERTIFICATE: Title Insurance Company hereby certifies that title to the above- described property is vested in the Owner(s). [Signature of Authorized Agent] FORM A-6: MORTGAGEE CONSENT TO DEDICTION MORTGAGEE CONSENT TO DEDICATION: The undersigned holders of mortgage interests and liens against the property offered for dedication and for transfer to the public and to Park County consents and approves of such dedication and transfer and subordinates and releases its interests to such dedicated and transferred property In Witness Whereof, we do hereunto set our hands and seals this ____day of [Printed Name of Mortgage Interest Holder] (If by corporation, president signs, secretary attests and corporate seal is affixed) [Insert notarization conforming to applicable requirement of state law for mortgagee’s place of execution.] ---PAGE BREAK--- Page 9 of 10 Major Subdivision Final Plat – Revised October 2025 APPENDIX B APPLICANT CERTIFICATION REGARDING NOTICE TO MINERAL ESTATE OWNER I, submitted an application for land use approval from Park County generally described as: Conditional Use Permit Determination of Location and Extent of Public Facilities Use Planned Unit Development with Rezoning Special Use Permit; (Telecommunications, Wetlands) Subdivision; (Major Preliminary Plan, Major Final Plat, Minor, Sketch, Combined) I understand that state law, found at CRS 24-65.5-101 through 24-65.5-104, imposes specific legal requirements involving my providing written notice to the mineral estate owner of my application. I HEREBY CERTIFY that I have complied with the notice requirements imposed upon me by CRS 24-65.5-101 through 24-65.5-104. Signature of Applicant Print Name For County Use Only Application Name/Case ---PAGE BREAK--- Page 10 of 10 Major Subdivision Final Plat – Revised October 2025 APPENDIX C AFFIDAVIT OF UNDERSTANDING I, the undersigned applicant, hereby acknowledge and agree to the following terms and conditions related to the submission of my application to the Park County Development Services Department. 1. ACKNOWLEDGMENT OF APPENDIX C REQUIREMENTS: I understand that, pursuant to Appendix C – Development Review Fees of the Park County Land Use Regulations, all application fees are non-refundable once an application has been received by the County, regardless of its status or outcome. 2. RESPONSIBILITY FOR COMPLETENESS: I acknowledge that it is solely my responsibility to ensure that all required materials, forms, maps, and supporting documentation are submitted in full compliance with the applicable Land Use Regulations and departmental procedures. 3. INCOMPLETE, WITHDRAWN, OR DENIED APPLICATIONS: I understand that any application that is incomplete, withdrawn, or denied—whether administratively or by action of the Board of County Commissioners—shall not be eligible for reimbursement, credit, or transfer of any portion of the fee paid. Any subsequent or corrected submittal shall constitute a new application and require payment of the applicable fee as set forth in Appendix C. 4. CERTIFICATION: I affirm that I have read and fully understand this affidavit and the non- refundable nature of the application fee as described in Appendix C. I further acknowledge that this affidavit shall be retained as part of the official record of my application. Applicant Name: Mailing Address: Project Name / Type: Signature of Applicant Print Name STATE OF ) ss. COUNTY OF Acknowledged before me this day of 20__, Notary Public Witness my hand and official seal. My Commission Expires: