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C) U IN <br /> APPL CAT OVA KE E KTF— AS OH <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> . P FILE NUMBER : TE - <br /> � < < FO ��' <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Applicant Information <br /> Name : A ci) <br /> Address : <br /> Phone : — L <br /> Permit Information <br /> Permit Number( s ) : Date Approved : <br /> Approving Agency : ❑ Staff ❑ Planning Commission ❑ Board of Supervisors <br /> Expiration Date : Extension Requested on : 2 <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 /> =jIftm r <br /> r <br /> How much additional time is being requested : <br /> NOTE : Time Extensions can be granted for up to 1 year for development applications and up to 6 years for subdivisions , <br /> SIGNATURE <br /> Signature : Date : <br /> �Z , <br /> m7 7 <br /> SIGNATURE n <br /> File No : OA - j C1 L900 7 r� ( Receipt No . Z j �/ <br /> 03 <br /> Accepted by : Date : Zl � ZU Z 1 <br /> F : \DEVSVC\Planning Application Forms\ Page 2 of 2 <br /> Time Extension . doc ( Revised 9 - 30 - 15) <br />