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SIN. APPLICATION TIME EXTENSION <br /> L' <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> �`'•. :a FILE NUMBER: TE- <br /> SIF i- <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> nw <br /> Applicant Information <br /> Name: - �% �S'S0/v >S <br /> Address: <br /> Phone: B3 — Z / 576 LFd'2 — 023 s r <br /> Permit Information <br /> Permit Number(s): - 3OD l Date Approved: <br /> Approving Agency: ❑ Staff Planning Commission ❑ Board of Supervisors <br /> xpiration Date: 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 /> /tf r e- _ !fie 2 AceL <br /> tea' AOZi Jd1-1s e•t 5, <br /> c st S (240 2,072v ze 6 <br /> Pe-11 <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. <br /> I Date: ,�i;Z- O <br /> SIGNATURE <br /> File No: Receipt No. <br /> Accepted by Date: <br /> F\DEVSMPlanning(ppiicetion Formsl , Page 2 of 2 <br /> Time Eatenslan.dw(Revised 10-1"4) <br />