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• 5 . Will the pro jec.t _ - <br /> a • generate objectional odors : 1110 <br /> b. generate any discharge into surface waters : <br /> C . venerate or store hazardous materials : / <br /> d• expose people to any haza dous materials or situations : <br /> e • displace people: <br /> f . use significant amounts of energy or natural resources :_& <br /> g , cause congestion on dways or at interchanges or intersec- <br /> tions : <br /> SIGt�TURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> er (owner includes partner , trustee , trustor , or <br /> Leca1 Property Own <br /> corporate officer . ) <br /> Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and that t }rue and correct. <br /> he foregoing is .. <br /> ...............4=4 <br /> ( ignature ) ( `e ) <br /> r <br /> Minor Subdivision <br /> - 10 - ( 6/86 ) <br />