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PARK COUNTY COLORADO New Address Request Form GIS / Mapping Department P.O. Box 571 Fairplay, CO 80440 Phone (719) 836-4287 / Fax (719) 836-4351 Email: [EMAIL REDACTED] Please fill in as much as you can and return form to Park County GIS by fax, email, or mail. * indicates required fields * DATE * OWNER * PHONE EMAIL TAX SCHEDULE NO. * APPLICANT FAX * LEGAL DESCRIPTION OF PROPERTY (metes & bounds; or subdivision, filing & lot): Address request is for: (check all that apply) [ ] Permit (bldg/driveway/septic) [ ] Other (describe) * What is the name of the road (county, state or private) that your driveway will access? Addresses are determined by the driveway location. Please include detailed information describing the location of the proposed or existing driveway relative to your land parcel. Include additional page as needed. What is the mileage (to the nearest 10th of a mile) to your driveway location from the start of the road or from the nearest mile marker? What are the nearest known addresses on the road accessing the property that this address is requested for? 10/02/2017 Park County Mapping Every attempt is made to assign an accurate permanent address. Park County shall incur no liability in the event re-addressing becomes necessary or the property is deemed not to be a legal building site. PLEASE NOTE: If above listed property is less than 35 acres & not in a subdivision, please attach a copy of the current Warranty Deed complete with full legal (metes and bounds) description and a copy of the warranty deed with matching legal description recorded prior to January 1, 1975; OR a copy of a recorded resolution indicating approval for an exemption from subdivision. OR if the land is being purchased via a contract please attach a copy of the contract.