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5 . Will the project: <br /> a . generate objectional odors : NO <br /> b. generate any discharge into surface waters : <br /> C . generate or store hazardous materials: 0 <br /> d. expose people to any hazardous materials or situation <br /> e . displace people ; S . <br /> f . use significant amounts of energy <br /> g. cause congestion on roadways oratointerchanges r naturalsorrcesinterseec- <br /> tions; <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> Legal Property Owner (owner includes partner, trustee, trustor, <br /> corporate officer . ) or <br /> UOwner 's legal agent (attach proof of the owner 's consent <br /> the application ) , to file <br /> and that the fo going is true and correct. <br /> � C` <br /> (Signature <br /> (Date ) <br /> X <br /> I <br /> I <br /> I <br /> I <br /> I <br /> i <br /> i <br /> i <br /> Minor Subdivision - 10 - I ' <br /> ( 6/86 ) <br /> • I <br />