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5 .' Will the project: <br /> a . generate objectional odors : N� <br /> b. generate any discharge into surface waters : Nn <br /> C . generate or store hazardous materials : N� <br /> d. expose people to any hazardous materials or situations : No <br /> e . displace people : No <br /> f . use significant amounts of energy or natural resources : No <br /> g . cause congestion on roadways or at interchanges or intersec- <br /> tions: No <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> L i Legal Property Owner (owner includes partner, trustee, trustor, or <br /> corporate officer . ) <br /> 1=! Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and h t t e foregoing is true and correct. <br /> 09 <br /> % �7 J <br /> (Signature ) (Date ) <br /> Use Permit Application - 10 - ( 6/86 ) <br />