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5 .. Wili the project: <br /> a . generate objectional odors : <br /> b. generate any discharge into surface waters : No <br /> C . generate or store hazardous materials: W <br /> d. expose people to any hazardous materials or situations: N= <br /> e . displace people: No <br /> f . use significant amounts of energy or natural resources: No <br /> g . cause congestion on roadways or at interchanges or intersec- <br /> tions: N <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 t at the fore ing is true and correct. <br /> (Date ) <br /> �Slgnatilre ) <br /> Use Permit Application <br /> - 10 <br />