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5 . Will the project: <br /> a . generate objectional odors : Q(:D <br /> b. generate any discharge into surface waters : <br /> c . generate or store hazardous materials : 0(77) <br /> d. expose people to any hazardous materials or situations :�— <br /> e . displace people: L)(7) <br /> f . use significant amounts of energy or natural resources :_ <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions : Q <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 /> an t' e f egos is true and correct. <br /> (Signature ) (Date ) <br /> Minor Subdivision - 10 - ( 6/86 ) <br />