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5 . Will the project: <br /> a . generate objectional odors : Nn <br /> b. generate any discharge into surface waters : Nn <br /> c . generate or store hazardous materials: Nn <br /> d. expose people to any hazardous materials or situations : Nn <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 /> ❑ Legal Property Owner (owner includes partner, trustee, trustor, or <br /> corporate officer . ) <br /> LJOwner ' 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 <br /> Si ature ) (Date ) <br /> � T <br /> Sign ture) (Date) <br /> Minor Subdivision - 10 - ( 6/86 ) <br />