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� . 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 : no <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 /> �x Legal 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 the foregoing is true and correct. <br /> (Signat re ) (Date ) �— <br /> x <br /> Major. Subdivision - 10 - (6/86 ) <br />