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5 . Will the project: <br /> a . generate objectional odors : ,moo <br /> b. generate any discharge into surface waters : do <br /> C . generate or sore hazardous materials : <br /> d. expose people to any hazardous materials or situations : --)Vo-- <br /> e . <br /> ituations : oe . displace people : ' A-70--- <br /> f . use significant amounts of energy or natural resources : <br /> g . cause congestion on roadways or at interchanges or intersec- <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 , 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 /> i <br /> f <br /> h <br /> Minor Subdivision - 10 - ( 6/86 ) <br />