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ip <br /> APPLICATION - �1ME EXTENSION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMppENT <br /> FILE NUMBER: TE- Q14" o'woo 10 <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Applicant Information <br /> Name: <br /> Address: ° <br /> 9 S d <br /> Phone: <br /> Permit Information <br /> Permit Number(s): Date Approved: <br /> Approving Agency: ❑ Staff ❑ Planning Commission ❑ Board of Supervisors <br /> Expiration Date: I 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 /> schedule: <br /> ^� O <br /> o � <br /> 6 o a <br /> 6 <br /> CJ <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: Dates <br /> SIGNATURE / <br /> File No: Receipt No. QL{t✓j lj <br /> Accepted by: Date: 7.7 —U <br /> F.\DEVSVC\Planning Application Fonos\ Page 2 of 2 <br /> Time Extension.doc(Revised 10-19-04) <br />