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5 . Will the project : . <br /> a . generate objectional odors : N 0 <br /> b. generate any discharge into surface waters : <br /> C . generate or store hazardous materials : <br /> d. expose people to any hazardous materials or situations : <br /> e . displace people: <br /> f . use significant amounts of energy or natural resources : <br /> - <br /> g. cause congestion on roadways or tinterchanges or intersec- <br /> tions : Jt/ <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> FUI Legal Property Owner (owner includes partner, trustee, trustor, or <br /> corporate officer . ) <br /> uOwner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application) , <br /> an4 that the foregoing is true and correct . <br /> (Signature ) (Date ) <br /> c;*^ p�^val Application - 8 - ( 6/86 ) <br />