Yes, there is room without ramps but a helper or an alligator floor jack (or both) REALLY help. My wife and I installed ours without ramps or stands. We are both in our 70s. Maybe that's why we needed the jack
But seriously, it's a lot to hold and try to get bolts started at the same time while lying flat in your back without some extra hands.
I guess there must have been some changes to the rear bumper area after my 2010 CR-V was made as there was no cutting required to install the Curt 13555 tow hitch. Glad I only had to lay on my back for about 30 minutes or so installing the hitch. I think if I had to do any cutting on the car I might have a can of spray paint with me to cover any paint nicks I might cause.
No cutting required on the car itself....just on a plastic underpanel. That cut is made after the panel is removed from the car. Simple to measure and cut. BUT...U-Haul has devised a way to avoid the cutting. They just throw your whole panel away. Problem solved. I saved the piece I cut out and trimmed and epoxied it back in just to try to keep winter salt etc. from getting where Honda didn't intend it to be.