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5 . Will the project: <br /> a . generate objectional odors : No <br /> b. generate any discharge into surface waters : No <br /> c. generate or store hazardous materials : No <br /> d. expose people to any hazardous materials or situations : No <br /> e . displace people : No <br /> f . use significant amounts of energy or natural resources : o <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions : No <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> gal Property Owner (owner includes partner, trustee, trustor, or <br /> corporate officer . ) <br /> uOwner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and that he foregoing is true and correct <br /> ��.) <br /> gnature ) (Date ) <br /> -7D <br /> Vo f� ()(Ale <br /> Major Subdivision - 10 - (6/86 ) <br />