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Page 1 of 10 Conditional Use Permit – Revised October 2025 For County Use Only Planning Department Confirmation of Current Zone District: Print Full Name PARK COUNTY APPLICATION FOR CONDITIONAL USE PERMIT NON-REFUNDABLE APPLICATION FEE: $1700 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 receipt and approval of the complete application the case will be placed on the Planning Commission agenda. 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) 836-4268, 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 No. and Email B. PROPERTY INFORMATION Complete Legal Description of Property Proposed for the Conditional Use Permit (attach additional page, if necessary): Street Address of Property: Property’s Total Acreage: Current Zone District of Property: ---PAGE BREAK--- Page 2 of 10 Conditional Use Permit – Revised October 2025 Requirements for a Conditional Use Permit Article V, Division 5, Section 5-501 C. APPLICATION REQUIREMENTS 1. Application Fee. An application fee in the amount of $1700 must be paid at the time of submission of the application. Make the check or money order payable to: 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. Proof of ownership in the form of a recorded Warranty Deed. This can be obtained at the Park County Clerk and Recorders office. 4. A legal description of the subject property prepared by a licensed Colorado land surveyor. 5. 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). 6. A list of names and mailing addresses of all owners of adjacent property to the property subject to the proposed Conditional Use Permit, this information is at the Park County Assessor’s Office. 7. A copy of all recorded covenants that apply to the subject property. 8. Current Conditions Map including, in one or more mapped or graphic formats the following information: a. Topography of the property subject to the Conditional Use Permit shown in elevation contours of not more than twenty (20) or forty (40) foot increments. Applicants are encouraged to use USGS or other commercially available topographic maps. b. Points of access to the property, internal roads and trails including widths and approximate grades. The Current Conditions Map must illustrate how access is obtained from the subject property to the nearest road or highway. c. Where any access to the property subject to the Conditional Use Permit application is obtained from a road, trail easement, driveway, historic use, or other private right of access other than an adjacent County owned right-of-way, the applicant shall provide evidence of permanent legal right of access. For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 3 of 10 Conditional Use Permit – Revised October 2025 Such evidence may include deed, easement agreement, or attorney opinion of legal right of access. d. Natural features of the property subject to the Conditional Use Permit application, including wetlands, riparian areas, water bodies, (e.g. lakes, ponds, streams, whether continuous or seasonal) and slopes greater than thirty percent 9. A site plan drawn to a constant scale showing the precise locations and dimensions of all property lines, easements, and existing and proposed structures and uses; including but not necessarily limited to vehicular and pedestrian access, parking, landscaping, lighting, and utility infrastructure. 10. If the proposed Conditional Use pertains to property located in a geological hazard area according to the geological hazard map, then the application must contain a geo-technical report prepared by a qualified professional geologist addressing the presence and extent of any geological hazards, including but not limited to, underground excavations on/or adjacent to the subject property and radioactive or toxic materials and/or minerals. 11. A Vicinity Map of where the proposed property is located within Park County. 12. The property must be clearly identified with the address and posted according to the Park County address requirements (attached). 13. Any other studies, reports, plans, or drawings that are judged necessary by the Planning director to ensure compliance with the Standards for Approval of a Conditional Use Permit (Section 5-503 of the Land Use Regulations). 14. A written proposal describing the existing use and proposed conditional use. For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 4 of 10 Conditional Use Permit – Revised October 2025 Note: All applications for a Conditional Use Permit for a Single Family Dwelling (not related to mining or oil or gas production) in a Mining Zone District shall meet all of the following requirements of Article V Section 5-311, Table Footnotes #2 1. All applications, including the required geo-technical report, shall be forwarded to the Colorado Geological Survey for a review and evaluation of the proposed use and site constraints. The applicant shall pay all costs assessed of charged by the Colorado Geological Survey for the review and processing of the application. Within fifteen (15) days following the County’s receipt of a report from the Colorado Geological Survey, the applicant shall submit a written response to the Planning Director/County Designee addressing in detail the applicant’s proposed methods for mitigating any hazards or concerns identified by the Colorado Geological Survey. Applicants are strongly encouraged to adopt and employ all mitigation measures recommended by the Colorado Geological Survey. No application shall be deemed complete and no review of the application by the County shall be initiated until an evaluation and report from the Colorado Geological Survey is received by the County, the applicant has paid all fees associated with such review by the Colorado Geological Survey, and the applicant has submitted its response to the Planning director/County Designee as required by this paragraph. 2. Applicants shall submit a report addressing the absence or presence of commercially valuable mineral resources on the proposed site and adjacent sites as part of the application. The applicant bears the burden of establishing that the proposed residential use does not conflict or interfere with the mining of mineral resources located within the property described in the application or within adjacent properties. 3. Single Family Dwelling Unit (Not related to Mining or Oil or Gas Production) shall be deemed incompatible with the purpose and intent of the Mining Zone District and no Conditional Use Permit shall be granted by the County unless the applicant establishes by competent and sufficient evidence presented to the County that: a. The residential use meets all review standards for Conditional Uses contained in Section 5-503 of the Park County Land Use Regulations; and b. The proposed residential use on the site will not present a hazard to the occupants of the residential structure or that hazards identified for the site are or will be mitigated by the applicant; and c. The proposed residential use will not conflict or interfere with the mining of mineral resources located within the property described in the application for conditional use or on adjacent properties; and d. The proposed residential use will not interfere with or impair historical access to adjacent uses, properties, or mining claims; and e. The applicant has delivered to the County a signed an notarized certification that proper notice has been provided to the mineral estate owner pursuant to and in accordance with Colorado Revised Statutes §24-65.5-103, or a certification that such notice is not required because the surface estate has not been detached from the mineral estate for the property described in the application. A form of certification is provided in Appendix B of the Land Use Regulations and is attached. For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 5 of 10 Conditional Use Permit – Revised October 2025 4. If the application for Conditional Use is approved, then the applicant may be required to record documentation prepared by the County Attorney disclosing the potential for geologic hazards at the property, assuming the risk associated with non-mining use of the property, and indemnifying the County from all injury and damage claims resulting from said use of the property. Note: Refer to Park County Land Use Regulations Article V Standards for Approval of Conditional Use Permit. For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 6 of 10 Conditional Use Permit – Revised October 2025 D. APPLICANT AND LANDOWNER SIGNATURES: The undersigned applicant and landowner hereby verifies and affirms 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 $ 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 7 of 10 Conditional Use Permit – 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 10 Conditional Use Permit – 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: ---PAGE BREAK--- Page 9 of 10 Conditional Use Permit – Revised October 2025 “POSTED” ADDRESS REQUIREMENTS Park County Land Use Regulation Section 7-1207 Address Number Signage Park County requires properties undergoing development to have a permanent address posted. This address post is permanent and is not just for the inspector but is for the use of the Fire Department, Sheriff and Emergency Services. The street address numbers need to be posted on the property prior to the preliminary inspection of the driveway. Numbers shall be attached to a 4” X 4” treated wood or redwood post. The post shall be placed at the driveway no further than 5 feet from the property line. Note: The post must not be placed in the county road right-of-way. The top of the post shall be installed, in a permanent fashion, a minimum of 48 inches above the ground. If the ground is frozen, place the post in a 5 gallon bucket filled with sand or rock until the post can be permanently installed into the ground. The sign specifications are shown with the below two examples. * Note: Contact your local Fire Protection District for signage information Type of Sign specifications for numbers is attached. 1 2 3 4 *Numbers attached to both sides of post 1 2 3 4 ---PAGE BREAK--- Page 10 of 10 Conditional Use Permit – Revised October 2025 SIGN SPECIFICATIONS Standard Size - 6” x 18” Standard Color – Green Background with White Reflective Numbers