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T <br /> 5 . Will the project: <br /> a. generate objectional . odors : NO <br /> b. generate .any-,di s charge, into surface waters: NO. : .... <br /> C. generate ,or store hazardous materials: NO <br /> d. expose people to any hazardous materials or situations: NO <br /> e. displace people: _ NO <br /> f. use significant amounts of energy or natural resources: NO i <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions: NO <br /> r ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one) : <br /> �X Legal PropertylOwner (owner includes partner, trustee, trustor, or <br />! corporate officer . ) <br /> u Owner 's legal agent (attach proof of the owner's consent to file <br /> the app n) , <br /> i <br /> an tha a fore,going.,;is true: and, correct,. <br /> i <br /> T. CARROLL (Date) <br /> i MERERNO H E. DAH <br /> KIRITKUMAR B. PATEL <br /> i <br /> cuQa 'i� J.,w ! 5 7 <br /> RONALD L. TOWERY " <br /> P <br /> LEE D. TOWERY <br /> Major Subdivision - 10 _ (6/86 ) <br /> i <br />