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APPLICATION - TIME EXTENSION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> TO BE COMPLETED BY THE APPLICANT,PRIOR TO FILING THE APPLICATION,; . <br /> APPL'ICANT'INFORMATION <br /> Name: — 1- <br /> Address: 1, 2 <br /> Phone: f CcLl I <br /> PERMIT'INFd RMATION <br /> Permit Number(s): �1 Date Approved: = g <br /> Approving Agency: ❑ Staff Planning Commission ❑ Board of Supervisors <br /> Expiration Date: 5-. LG( - (D Extension Requested on: Z I C� <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: � � P 4 <br /> NO TE.- Times Extensions can be granted for up to 1 year for development applications and up to 5 years for subdivisions. <br /> SIGNATURE <br /> Signature: i� •, -- �ti;moi->!� Date: <br /> STAFF USE ONLY <br /> File No: �) Z� Receipt No. <br /> Accepted by: Date: U r <br /> -2- <br />