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TIME EXTENSION REQUEST
City of Anaheim - Planning Department - Code Enforcement Division
Date:
/
Month
/
Day
Year
Date
Case #:
Violation Address:
*
Days Requested:
*
15 Days
30 Days
Reason for Extension Request:
*
Signature:
*
Print Name:
*
First Name
Last Name
Phone Number
*
E-Mail:
example@example.com
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Should be Empty: