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5 . Will the project : <br /> a . generate objectional odors : NO <br /> b. generate any discharge into surface waters : NU <br /> C . generate or store hazardous materials : NO <br /> d. expose people to any Ohazardous materials or situations : <br /> e . displace people : N <br /> f . use significant amounts of energy or natural resources : NU <br /> g . cause congestion on roadways or at interchanges or intersec- <br /> tions : <br /> SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> �X Legal Property Owner (owner includes partner , trustee, trustor , or <br /> corporate officer . ) <br /> LJ Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and that the r go' g is true and correct . <br /> Mt <br /> 9r� <br /> ( ignature ) ( ate ) <br /> Minor Subdivision - 10 - ( 6/86 ) <br />