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5 . Will the project: <br /> a . generate objectional odors : /70 <br /> b. generate any discharge into surface waters: #20 <br /> c . generate or store hazardous materials : /711111 <br /> d. expose people to any hazardous materials or situations: ')a <br /> e . displace people: 1719 <br /> f . use significant amounts of energy or natural resources : nO <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions: /70 <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 foregoing is true and correct. <br /> - - / <br /> (Si atur ) (Date ) <br /> Minor Subdivision - 10 - (6/86 ) <br />