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5 . Will the project: <br /> a . generate objectional odors :�� <br /> b. generate any discharge into surface waters :_ <br /> C . generate or store hazardous materials: +---L^ <br /> d. expose people to any hazardous materials or situations: <br /> e . displace people:J=.A O <br /> f . use significant amounts of energy or natural resources : <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions: ��1Q <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> 1 Property Owner (owner includss. partner, trustee, trustor, or <br /> corporate officer . ) <br /> LJ Owner 's legal agent (attach proof of the owner 's consent to file <br /> the application) , <br /> and that the fore o' ng is true and correct. <br /> (Signature ) (Date ) <br /> Minor Subdivisicn - 10 - ( 6/86 ) <br />