APPLICATION FORM FOR GEOLOGIC HAZARD EXEMPTION
Applicant: _________________________________________ Telephone ______________________ Fax ___________________
Address: ___________________________________________ Zip Code _________________ e-mail _______________________
Premises Involved: Development Plan/Subdivision Plat Name: _________________________________________________________
Tax Schedule No(s). __ __ __ __ __ - __ __ - __ __ __, __ __ __ __ __ - __ __ - __ __ __
(This can be obtained from the El Paso County Tax Assessor located at 27 E. Vermijo Avenue on the 2 nd Floor; phone: 520-6600 or at their web site http://www.land.elpasoco.com
). An application review fee will be required to accompany these applications (make checks payable to City of Colorado Springs). The fee schedule is as follows:
In accordance with the Geologic Hazard Ordinance, City Planning, in consultation with the City Engineer, may waive the requirement for the submittal of a Geologic Hazard Study for development proposals which exhibit all of the following characteristics:
1.
No portion of the project lies within the Hillside (HS) Overlay Zone District. This does not pertain to property that has received a
Hillside Exemption from a Geologic Hazard Study where a geologist or Geotechnical Engineer has determined that Geologic
Hazards are not present; and,
2.
The project contains no slopes (existing or proposed) which are unstable or potentially unstable; and,
3.
The project site has no history of underground mining or subsidence activity; and,
4.
The project site exhibits no geologic hazards, as defined in the Zoning Code which pose risks to the proposed project, other than seismicity, radiation (radon), expansive/compressible soils and bedrock (except steeply dipping expansive bedrock), shallow water table or springs, all of which can be mitigated with proper foundation design and construction practices; or,
5.
The project was covered in a previously reviewed and approved Geologic Hazard Study which covers the project site is currently on file with the City, and said study is considered to be relevant. (Note: If this type of exemption is being considered the following information must be provided: title, author, file number and date of preparation).
I hereby formally request that the _________________________________________________________ development be exempted from the requirement to submit a Geologic Hazard Study on the basis that review and on-site observation of the project has confirmed that all of the above referenced exemption criteria have been met. I hereby attest that I am a:
____________ Professional Geologist as defined by CRS 34-1-201(3); or,
____________ Professional Engineer as defined by Board Policy Statement 50.2: “Engineering in Natural Hazards Areas” of the
Colorado State Board of Registration for Professional Engineers and Professional Land Surveyors. Board authority as defined by CRS 12-25-107(1).
Geohazard Exemption (geohazexemp.doc) Last Modified: 07/08/2009 1

Submitted for and on behalf of ___________________________________________________________
Submitted by: _________________________________________________________ Date: _____________________________
SEAL
City Engineering ___________________________________ Date Received _______________________________________
Approved: ________________________________________ Denied: ____________________________________________
Approval Date: _____________________________________ Denial Date: ________________________________________
Conditions/Reasons: _______________________________________________________________________________________
________________________________________________________________________________________________________
________________________________________________________________________________________________________
City Planning ______________________________________
Approved: ________________________________________ Denied: ____________________________________________
Approval Date: _____________________________________ Denial Date: ________________________________________
Conditions/Reasons: _______________________________________________________________________________________
The City of Colorado Springs-Planning Group is committed to ensuring that all of our services are accessible to those with disabilities. We encourage participation by all individuals. If you have a disability, advance notification of any special needs will help us better serve you. Please call City Planning at 719-385-5905 to request any special service that you may require.
A one (1) week advance notice to allow us to accommodate your request is appreciated.
Geohazard Exemption (geohazexemp.doc) Last Modified: 07/08/2009 2