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5 . Will the project: <br /> a . generate objectional odors : �G) <br /> b. generate any discharge into surface waters: / <br /> 70 <br /> c . generate or store hazardous materials: <br /> d. expose people to any hazardous materials or situations: <br /> e . displace people: <br /> f . use significant amounts of energy or natural resources : <br /> g. cause congestion_on roadways or at interchanges or intersec- <br /> tions: ,✓nom/! <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 /> (Signature ) (Date ) <br /> Minor Subdivision - 10 - (6/86 ) <br />