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APPLICATION - 11ME EXTENSION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: TE- r A <br /> ��FORN <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> a n Applicant Information <br /> Name: C- 1� ACL q4 / rCr lJ !- <br /> Address: 3Q S <br /> on 3 & <br /> Phone: Z,Q - 55`1'7- 7 1 3 <br /> Permit Information <br /> Permit Number(s): A - 15S OC)7 I Date Approved: <br /> Approving Agency: ❑ Staff Planning Commission ❑ Board of Supervisors <br /> Expiration Date: --I - -�) I . D-A I Extension Requested on: - 23- C� <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 /> �i C clan S cJYI 1 9 U Q <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 5 years for subdivisions. <br /> r <br /> SIGNATURE <br /> gqn - -- Date: <br /> ature: 3- <br /> SIGNATURE <br /> File No: Receipt No. <br /> Accepted by: Date: <br /> F1DEVSMPlanning Application Fonns\ Page 2 of 2 <br /> Time Ectension,doc(Revised 10-19.04) <br />