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APPLICATION - TI1l-17E EXTENSION <br /> _ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> CTO BE COMPLETED BY THE APPLICANT PRIOR TO FILING,THE APPLICATION <br /> A`PPLICANT INFORMATION <br /> Name: l _ )/—� Ue V <br /> Address: q V Q "t l b'f-z�. <br /> P q �U <br /> Phone: Gt <br /> :`PERMIT INFORMATION <br /> PermitNumber(s): —��—Q(5 Date Approved: <br /> Approving Agency: ❑ Staff ❑ Planning Commission ❑ Board of Supervisors <br /> Expiration Date: j Extension Requested on: <br /> Give the reason for the request for a time extension(include the circumstances that have prevented the project from preceding on <br /> schedule: <br /> r <br /> 0 0 'w l/ ✓ t c S <br /> pL vv <br /> t <br /> How much additional time is being requested: <br /> NOTE: Times Extensions can be granted for up to 1 y ar for development applications and up ars for subdivisions. <br /> f ; SIGNATURE <br /> Signature: Date: j c� <br /> STAFF.USE ONLY .F <br /> File No: �—/' < ` 4 1 ^ d"� Receipt No. <br /> II Accepted by: (_��V �� I Date: <br /> -2- <br />