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°p4UIN APPLICATION - ME EXTENSION <br /> �:•�:fog <br /> < SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> FILE NUMBER: TE- <br /> �rFOR� <br /> TO BE COMPLETED BY THE APPLICANTPRIOR TO FILING THE APPLICATION <br /> Applicant Information <br /> Name: <br /> Address: /) j_ n F <br /> ,J LoN x <br /> Phone: <br /> . - G,t . " :` •� x '7- Permit Information _ <br /> Permit Number(s): ,i .f Date Approved: <br /> Approving Agency: Staff ❑ Planning Commission ❑ Board of Supervisors <br /> Expiration Date: 61011 ) 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 /> 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: — <br /> SIGNATURE <br /> File No: /2"G D / 7 3 D Receipt No. <br /> Accepted by: ��� . '�Ci�ti1�:.. Date: � /cl,,Zw <br /> F.OEVSVQPlanning Application Forms\ Page 2 of 2 <br /> Time Extension.doc(Revised 10.19-04) <br />