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5 . Will the project: <br /> a . generate objectional odors : Nn <br /> u. generate any discharge into surface waters: NO <br /> C . generate or store hazardous materials: Nn <br /> d. expose people to any hazardous materials or situations : NQ_ <br /> e . displace people: _ Nn <br /> f . use significant amounts of energy or natural resources :N_ <br /> g . cause congestion on roadways or at interchanges or intersec- <br /> tions : Nn <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 /> LJ Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application) , <br /> and. that the foregoi—ng is true and correct. <br /> (Signa �1 (Date ) <br /> Minor Subdivision - 10 - ( 6/86 ) <br />