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5 . Will the project: <br /> a . generate objectional odors :_ �o <br /> b. generate any discharge into surface waters : A) <br /> C . generate or store hazardous materials : G <br /> d. expose people to any hazardous materials or situations : o <br /> e . displace people : <br /> f . use significant amounts of energy or natural resources : No <br /> g. cause congestion on roadways or at interchanges or inter�ec- <br /> tions: o <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> Legal Property Owner (owner includes partner, trustee, trustor, or <br /> corporate officer . ) <br /> Owner ' s legal agent (attach proof of the owner 's consent to file <br /> the application ) , <br /> and that e---;Eore0 g s true and correct . <br /> v <br /> Sign ture') /tDa/te <br /> Major Subdivision - 10 - (6/86 ) <br />