Laserfiche WebLink
APPLICATION - TIME EXTENSION <br /> y�\ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT(D�1EEPARTMENT <br /> \' FILE NUMBER:-W' P`/7_O /003 Z_ <br /> ��1koA <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> a _ 'Applicant Information <br /> -Name: 1\J_r Sl(V 6 H <br /> Address: - D y71- <br /> o _ - - <br /> Phone: �^ a -Jr ` �Lit, �- - <br /> Permit Information <br /> Permit Number(s): Date Approved: <br /> Approving Agency: ❑ Staff ❑ Planning Commission ❑ Board of Supervisors <br /> ,j-GiExpiration Date: 1 - O - 02o Extension Requested on: 11- 2,5-- <br /> Give <br /> ve 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: <br /> NOTE: Time Extensions can be granted for up to 1 year for development applications and up to 5 years for subdivisions. <br /> SIGNATURE _ <br /> Signature: Date: S �� <br /> SIGNATURE <br /> File No: - ;:.J � Lr Receipt No.'Q` <br /> Date: <br /> Accepted by: _ <br /> FSDEVSVC\Planning Application Forms\ Page 2 of 2 <br /> Time E~sion.dm(Revised 10.19-04) <br />