APPLICATION FEE: $100.00 RECEIVED

CASE# PB ________________

BLOCK , LOT(S)

LOCATION:

WARREN TOWNSHIP PLANNING BOARD

APPLICATION FOR EXTENSION OF PRELIMINARY APPROVAL

SITE NAME _______________________________________________________________________________

Application is hereby made for an extension of Preliminary:

□ Site Plan or □ Major Subdivision

Approval Approval

This extension is hereby made in accordance with N.J.S.A. 40:55D-49c, The applicant may apply for and the Planning Board may grant extensions of preliminary approval for additional periods of at least I year, but not to exceed a total extension of 2 years, provided that if the design standards have been revised by Ordinance such revised standards may govern.

ORIGINAL APPROVAL WAS GRANTED ON

(Original Resolution Date)

ORIGINAL APPROVAL EXPIRES:

(3Yrs. from above date)

PREVIOUSLY GRANTED EXTENSION TO:

(Date of first extension)

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APPLICANT’S NAME________________________________________________ PHONE __________________

ADDRESS:

ATTORNEY’S NAME____________________________________________ PHONE______________________

ADDRESS:

Please attach to this application a separate rider explaining your reasons for requesting this extension. Please indicate if you were delayed in any way, directly or indirectly from proceeding with the development because of delays in obtaining legally required approvals from other governmental entities.

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APPLICANT DO NOT WRITE BELOW THIS LINE

BOARD REVIEWED REQUEST ON _____________________________________________________________

EXTENSION GIVEN TO

THIS IS THE 1st / 2nd EXTENSION GIVEN.