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Page 1 of 8 Determination of Location and Extent – Revised October 2025 For County Use Only Planning Department Confirmation of Current Zone District: Print Full Name PARK COUNTY APPLICATION FOR DETERMINATION OF LOCATION AND EXTENT OF PUBLIC FACILITIES USE NON-REFUNDABLE APPLICATION FEE: $700 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 twenty (20) collated 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 No. and Email B. PROPERTY INFORMATION Complete Legal Description of Property Proposed for the Public Facility of Use (attach additional page, if necessary): Street Address of Property: Property’s Total Acreage: Current Zone District of Property: ---PAGE BREAK--- Page 2 of 8 Determination of Location and Extent – Revised October 2025 Requirements for a Location and Extent Determination Article IX, Division 3, Section 9-302 C. APPLICATION REQUIREMENTS 1. Application Fee. An application fee in the amount of $700 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 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). 5. A list of names and mailing addresses of all owners of adjacent property to the subject property. This information appears of record with Park County Assessor’s Office. 6. A Location and Extent Plan and Report shall be prepared on 24” x 36” paper at a commonly used engineering scale sufficient to illustrate the necessary location and extent of the proposal. The plan shall include the following information as a minimum: a. Name of proposed use/facility together with a narrative describing the purpose of the improvements, the range of impacts, and how these impacts are addressed; b. A complete legal description of the property containing the proposed use/facility prepared by a licensed and registered Colorado land surveyor; c. A vicinity map showing the location of the property in relation to commonly known features such as terrain and roads; d. Existing and proposed access to the site, including surfacing and width, all easements and drainages, all loading, parking and outdoor storage areas; e. Existing and proposed topography shown at two-foot (2ft) contour intervals, or another contour interval approved by the Planning Director or designee. Existing For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 3 of 8 Determination of Location and Extent – Revised October 2025 contours shall be shown with dashed lines and proposed contours with solid lines; and, f. The location, dimensions (including height) and uses of all existing and proposed structures, and the location and type of all exterior lighting; and, g. Source and availability of water and method of waste and wastewater disposal; and, h. An illustrative landscape plan showing all proposed landscaping materials, fences, walls, planters and any other existing and proposed features; and, i. All Utility lines and appurtenances. 7. A traffic study describing the transportation network and establishing the adequacy or inadequacy of the network to accommodate additional traffic generated by the proposed use/facility 8. A proposal for the method of guarantee of financing (letter of credit or performance bond) and a timetable for construction of public improvements. 9. The property must be clearly identified with the address and posted according to the Park County address requirements (attached). 10. Additional information may be requested by the Planning Director or designee to ensure compliance with this or any other applicable regulation or statute. Any information required above may be waived by the Planning Director when deemed unnecessary. Note: Refer to Park County Land Use Regulations Article IX for requirements of Location and Extent Determination. For County Use Only: Initial Receipt of the Required Information ---PAGE BREAK--- Page 4 of 8 Determination of Location and Extent – 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 5 of 8 Determination of Location and Extent – 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 6 of 8 Determination of Location and Extent – 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 7 of 8 Determination of Location and Extent – 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 8 of 8 Determination of Location and Extent – Revised October 2025 SIGN SPECIFICATIONS Standard Size - 6” x 18” Standard Color – Green Background with White Reflective Numbers