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J <br /> �°e= '�A� APPLICATION — TIME EXTENSION <br /> L: •y <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> c.,.� ::P FILE NUMBER: TIPA" 11 12 4 <br /> 9��FOR� <br /> TO BE COMPLETED BY THE APPLICANT PRIOR TO FILING THE APPLICATION <br /> Applicant Information <br /> Name: 'rielef4 <br /> Address: (o 3 t-?1C12— Gf� wl b G{� �jr722O^��oOs <br /> Phone: 15(,PC6 • 6 <br /> Permit Information <br /> Permit Number(s): A 7--+ Date Approved: $ • Z Zo I) <br /> Approving Agency: 21 Staff ❑ Planning Commission ❑ Board of Supervisors <br /> Expiration Date: 31 D,-t 1� I Extension Requested on: 3 a <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: 6)IQ t�,A42— <br /> NOTE: Time Extensions can be granted for up to 7 year for development applications and up to 5 years for subdivisions. <br /> SIGNATURE <br /> Signator I ,lam _ Date: <br /> SIGNATURE <br /> File No:- U Receipt No. I b <br /> Accepted by: Date: �j <br /> F:\DEVSVMPlanning Application Forms\ Page 2 of 2 <br /> Time Extension.doc(Revised 10-19-04) <br />