CASE # APP. FEE $100.00 RECEIVED

BLOCK , LOT(S)

LOCATION: ___________________________________

WARREN TOWNSHIP PLANNING BOARD

APPLICATION FOR EXTENSION OF MINOR SUBDIVISION FILING

Application is hereby made to extend the filing time for the above referenced minor subdivision.

This extension is hereby made in accordance with N.J.S.A. 40:55D-47(f) & (g). The Planning Board may extend the 190 period for filing a minor subdivision plat or deed. The Board may grant an extension of minor subdivision for a period determined by the board, but the period may not exceed one year of what would otherwise be the expiration date.

ORIGINAL APPROVAL WAS GRANTED ON

(Original Resolution date)

ORIGINAL APPROVAL EXPIRES:

(190 days 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.

* * * * * * * * * * * * * * * * * * * * * * * * * * * * * *

APPLICANT DO NOT WRITE BELOW THIS LINE

BOARD REVIEWED REQUEST ON .

EXTENSION GIVEN TO .

EXTENSION MAY NOT GO BEYOND .

(1 year from Original Approval date)