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APPLICATION - TIME EXTENSION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> { TO BE COMPLETED BY THE APPLICANT PRIOR TD FILINGTHE APPLICATION <br /> APPLICANT INFORMATION <br /> Name: C In 4 Q,. e <br /> Address: JtL4 S . bev <br /> I g53� i <br /> Phone: <br /> PERMIT INFORMATION :. ' <br /> Permit Number(s): 9— Cj �, Date Approved: q tp `I <br /> Approving Agency: Staff ❑ Planning Commission ❑ Board of Supervisors <br /> Expiration Date: -3/7-4 I b I Extension Requested on: - ISI b <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 /> 1 A. / ',4- <br /> How much additional time is being requested: <br /> NOTE.: Times Extensions can be granted for up to 1 year for development applications and up to 5 years for subdivisions. <br /> SIGNATURE <br /> Signature: �,.L Q... , . —� Date: L -) <br /> ' STAFF USE ONLY <br /> .F <br /> File No. --� Receipt No. <br /> Accepted by: Date: <br />