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5 . Will the project : <br /> a . generate objectional odors : A/C 4!r <br /> b. generate any discharge into surface waters : <br /> c . generate or store hazardous materials : �l/Q <br /> d. expose people to any hazardous materials or situations : e n <br /> e . displace people: A e n v <br /> f . use significant amounts of energy or natural resources : /l o <br /> g . cause coVstion on roadways or at interchanges or intersec- <br /> tions: <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 the foregoing is true and correct. <br /> /�_ &��Z .T4A / 3 <br /> (Sign tune ) (Date ) <br /> Minor Subdivision - 10 - (6/86 ) <br />