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   PARK COUNTY DEVELOPMENT SERVICES 856 Castello Ave • P.O. Box 517, Fairplay, CO 80440 Office: 719-836-4254 • Fax: 719-836-4268 www.parkco.us
5. Schedule No:*
6. Property Address:*
8. Legal Description
10. Metes & Bounds: Township:
11. Section:
12. Range:
14. OR
16. Subdivision:
17. Lot:
18. Block:
20. Filing:
21. Unit:
23. Property Owner
25. Name:*
27. Mailing Address:*
29. City:*
30. State:*
31. Zip Code:*
33. Home/Cell Phone:*
34. Other Phone:
36. Email Address:
38. Start Date *
39. End Date*
41. Type and number of Camping Unit(s):*
43. Sanitation Plan Narrative:*
45. Driveway Permit No:*
47. Plot Plan*

    Please include a plot plan of your property that shows the following: 

    1. The location of camp site
    2. The location of the driveway, roads, streets, right-of-ways, and access easements.
    3. Location of septic tank and leach field (if applicable)
    4. Any watercourse or wetlands All setback distances from campsite to all property lines
    5. Property line dimensions
    6. The project address, a north arrow, and preparation date
49. Recorded Warranty Deed
51. Conditions:

    Property owners may be granted a permit to camp for up to thirty (30) consecutive days in a calendar year, with one (1) 30-day renewal in any calendar year, under the following conditions.

    1. No more than two camping units per lot are allowed.
    2. Camping activities shall comply with all structure setbacks for the zone district
    3. Sewage shall be disposed of either at an off-site facility or by means of an on-site system. In either case, the facility or system must be currently permitted or approved by Park County.
    4. Trash shall be managed on-site and removed from the site regularly during camping and upon completion of camping. Bear resistant containers are highly recommended.
    5. Camping units shall have current licensing and registration and be in operable road worth condition, as applicable.
    6. Camping units must be removed when not being used under an active camping permit.
    7. Legal, permitted access is required per Article VII, Division 12, Section 7-1207. 8.Posted address is required in accordance with Article VII, Division 12, Section 7-1207 One additional 30-day permit renewal may be granted if a permitted on-site wastewater treatment system, consisting of a septic tank and soil treatment area, is used for sanitation.
53. Certification:
    I hereby certify that I have read and examined this application and know the same to be true and correct. I agree to abide by the conditions which are a part of the Temporary Use Permit per the Park County Land Use Regulations Section 5-712 regarding Camping on Vacant Residential (MR, R, R-20, R-35) and Mining (M) Parcels.
55. Signature*
56. Date
    Date

    Date
Leave This Blank:


58. 1. Receive an email copy of this form.
59. Email address

    This field is not part of the form submission.

60. Submit Submit and Print

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