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�UN APPLICATION — i IME EXTENSION <br /> \ < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> • Q..-��,..�P. FILE NUMBER: TE- ��- I�Q nb (Q <br /> ;FORS <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Applicant Information <br /> Name: CSIn bL4k1 <br /> Address: luss, n �V <br /> lA 7 S <br /> Phone: <br /> Permit Information / <br /> Permit Number(s): j Date Approved: <br /> Approving Agency: ❑ Staff /'0' Planning Commission ❑ Board of Supervisors <br /> Expiration Date: - b 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 /> sche• le: <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 /> �.Sigriature /lam Date: 2 20i —1 <br /> / SIGNATURE <br /> File No:TA— nlb o(0 Receipt No <br /> Accepted by: 1— Date: OI l tj <br /> F:\DEVSVC\Planning Application Forms\ Page 2 of 2 <br /> Time Extension.doc(Revised 9-30-15) <br />