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S . ' Will the project : <br /> a , generate objectional odors : AI `p <br /> b. generate any discharge into surface waters : me) <br /> C . generate or store hazardous materials : N O <br /> d. expose people to any hazardous materials or situations : A)6 <br /> e . displace people : N o <br /> f . use significant amounts of energy or natural resources : NO <br /> g. cause congestion on roadways or - at interchanges or intersec- <br /> tions: A) & <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 /> u 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 /> (Signa (Date ) <br /> A <br /> Minor Subdivision - - 10 <br /> 4v& <br />