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APPLICATION - MME EXTENSION <br /> y < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> • �4 •...:`.•:P FILE NUMBER: (T-E-" —0— 9 / <br /> ��FORN <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Applicant Information <br /> Name: <br /> Address: <br /> Phone: 4 <br /> Permit Information <br /> Permit Number(s): Date Approved:AW/L <br /> Approving Agency: ❑ Staff Planning Commission ❑ Board of Supervisors <br /> Expiration Date: Extension Requested on: J/ Z <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 /> How much additional time is being requested: 1 <br /> NOTE: Time Extensions can be granted for up to 1 year for development applic qns and4Ap to 5 years for subdivisions. <br /> SIGNATURE rl <br /> Signature: Date: / <br /> SIGNATURE <br /> File No: `> Receipt No. 1 <br /> Accepted by: Date: - - <br /> F:\DEVSVC\Planning Application Forms\ Page 2 of 2 <br /> Time Extension.doc(Revised 10-19-04) <br />