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5 . Will the project : <br /> a . generate objectional odors : /f/,n <br /> b. generate any discharge into surface waters : <br /> c . generate or store hazardous materials : //r <br /> d. expose people to any hazardous materials or situations : �o <br /> e . displace people : o <br /> f . use significant amounts of energy or natural resources : <br /> g . cause congestion on roadways or at interchanges or intersec- <br /> tions : /)p <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 /> L--J Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and t4t� the oregoirgis true and correct . <br /> t ------ 9/ ,/Z�/ <br /> (Signature ) (Date ) <br /> Minos Subdivision - 10 - ( 6/86 ) <br />