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5 . Will the project: <br /> a . generate objectional odors : ,!)♦ <br /> b. generate any discharge into surface waters : ,{Jo <br /> c . generate or store hazardous materials : ,�10 <br /> d. expose people to any hazardous materials or situations : No <br /> e . displace people: AA0 <br /> f . use significant amounts of energy or natural resources : A)& <br /> g . cause congestion 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 /> LJOwner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and th t the fore ping is true and correct. <br /> z o --ee- <br /> (Date ) <br /> (Signat r ) r/ <br /> Minor Subdivision - 10 - ( 6/86 ) <br />