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5 . Will the project : <br /> a . generate objectional odors : A10 <br /> b. generate any discharge into surface waters : <br /> c. generate or store hazardous materials : <br /> d. expose people to any hazardous materials or situations : <br /> e . displace people : /VO <br /> f . use significant amounts of energy or natural resources : <br /> A77,7- <br /> g. cause congestion on roadways ,gr at interchanges or intersec- <br /> tions : <br /> O SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> OLegal 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 oreg ing is true and correct. <br /> (Signa ure ) (Date ) <br /> Minor Subdivision - 10 - (6/86 ) <br />