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S . Will the project: (Minor Subdivision) <br /> a . generate objectional odors : No <br /> b. generate any discharge into surface waters : o <br /> c . generate or store hazardous materials : o <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 <br /> g . cause congestion on roadways or at interchanges or intersec- <br /> tions : No <br /> SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> 0 Legal Property Owner (owner includes partner, trustee , trustor , or <br /> corporate officer . ) <br /> LI Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and that theforegoing is true and correct ./ <br /> V/CCp Da e ) <br /> Minor Subdivision - 10 - ( 6/86 ) <br />