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For County Use Only Planning Department Confirmation of Current Zone District: Print Full Name PARK COUNTY APPLICATION FOR MAJOR SUBDIVISION SKETCH PLAN NON-REFUNDABLE APPLICATION FEE: $2000 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: Email Address: Telephone Owner’s Mailing Telephone B. PROPERTY INFORMATION Complete Legal Description of Property Proposed for the Major Subdivision Sketch Plan (attach additional page, if necessary): Street Address of Property: Property’s Total Acreage: Current Zone District of Property: ---PAGE BREAK--- Page 2 of 8 Major Subdivision Sketch Plan – Revised October 2025 Requirements for a Major Subdivision Sketch Plan Article VI, Division 4, Section 6-403 C. APPLICATION REQUIREMENTS 1. Application Fee. An application fee in the amount of $2000 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. 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 Sketch Plan is $750. Make the check or money order payable to the Park County Planning Department. 4. Proof of ownership in the form of a recorded Warranty Deed. This can be obtained at the Park County Clerk and Recorders office. 5. A legal description of the proposed subdivision prepared by a licensed 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 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 owners of adjacent property to the property subject to the proposed plat amendment, this information is at the Park County Assessor’s Office. 8. A Sketch Plan shall be drafted at a commonly used engineering scale. The size of the map sheet shall be twenty-four by thirty-six inch (24" x 36"). Where the required data cannot be clearly shown on one plan sheet, additional plan sheets of the same size may be used with easily identifiable match lines. At a minimum, the Sketch Plan shall contain: a. A title that prominently identifies the proposed name of the subdivision together with the phrase “Sketch Plan”; 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; For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 3 of 8 Major Subdivision Sketch Plan – Revised October 2025 d. A general vicinity map illustrating the location of the property; e. Approval certification and plat language Forms A-2 and A-7, as identified in Appendix A (attached) of the Land Use Regulations. The Board of County Commissioners may modify the form of certification and plat language only with the consent of the County Attorney, which shall be subject to final approval; f. If the Sketch Plan is submitted in support of a rezoning application for a Planned Unit Development (PUD) then, 1. The title of the Sketch Plan shall also include the phrase “Planned Unit Development”; 2. The Sketch Plan shall include information identifying all permitted land uses, setbacks, maximum heights, minimum and maximum lot sizes, proposed conditions or restrictions upon use, and other information governing the use of the property which is customarily associated with zone district restrictions or limitations; 3. The Sketch Plan shall include the following signature block in substitution and replacement for the County approval Form A-7 BOARD OF COUNTY COMMISSIONERS APPROVAL: The Board of County Commissioners by Resolution No. approved the Sketch Plan to accompany the conditional rezoning of the Property as a Planned Unit Development (PUD) on the day of 20__. BOCC Chairperson County Clerk (Seal) g. Location and type of natural features of the property including watercourses, lakes, topography, 100 year floodway and floodplain, rock outcrops/surface geology, geological hazards, wildlife corridors and known wildlife foraging areas, scenic vistas, and significant trees and vegetation; h. Approximate location of all existing man-made structures, utilities, streets, driveways, ditches, fences, hazards, or other physical improvements on the property or within 100 feet of the property proposed for subdivision; i. Approximate location of recorded or apparent easements or rights-of-way on the property or within 100 feet of the property; j. Approximate location and type of cultural and historic resources located within the property proposed for subdivision, including Historic Architectural Resources, Historic Archeological Resources, and Prehistoric Archeological Resources as defined in Article IV of these Land Use Regulations; k. Proposed location of residential, commercial and/or industrial development and other new improvements, including but not limited to buildings, access points, streets, alleys, pedestrian ways, parking areas, drainage ways and drainage detention areas, open space and parks, and proposed utilities and utility easements; For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 4 of 8 Major Subdivision Sketch Plan – Revised October 2025 l. Any other data or information essential to the evaluation as may be requested by the Planning Director to enable an adequate conceptual evaluation of the proposed subdivision. 9. A narrative statement describing the existing conditions and the proposed subdivision development including at a minimum; a. Total proposed development area in acres with a breakdown in percentages and amounts devoted to specific land uses; b. Zoning district(s) of the property and of all adjacent properties; c. Proposed zoning district(s) if a rezoning is being requested; d. If zoned for residential use or proposed for rezoning to a residential use, an approximation of the number and types of dwelling units; e. Anticipated providers of utilities for water, sewer, gas, electric and telephone; f. Proposal for preservation, protection, alteration, or removal of significant natural features and man-made characteristics of the site. 10. A fiscal impact analysis prepared by a consultant selected by the Planning Director or Designee describing the anticipated effect of the completed subdivision on the county’s finances. 11. All subdivisions proposing the use of five or more individual wells shall submit to the County an analysis prepared by a professional deemed qualified by the County to evaluate water delivery systems that compares the efficiency, cost effectiveness, and adverse impacts upon other wells of the proposed individual wells to the efficiency, cost effectiveness, and adverse impacts of a common or community water delivery systems(s) Note: Refer to Park County Land Use Regulations Article VI Standards for Approval of a Major Subdivision). For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 5 of 8 Major Subdivision Sketch Plan – Revised October 2025 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. For County Use Only: Verification of Date of Delivery and County Receipt of Application Print ---PAGE BREAK--- Page 6 of 8 Major Subdivision Sketch Plan – Revised October 2025 APPENDIX A 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 statures, 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-7: COUNTY SKETCH PLAN OR PRELIMINARY PLAN APPROVAL PARK COUNTY APPROVAL APPROVED as a [insert either: Sketch Plan or Preliminary Plan] by the Park County Board of County Commissioners, this ___day of 20__ subject to all applicable provisions of the Park County Land Use Regulations. ATTEST: Park County Clerk and Recorder Chairperson ---PAGE BREAK--- Page 7 of 8 Major Subdivision Sketch Plan – 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 8 of 8 Major Subdivision Sketch Plan – 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: