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5 . Will the project: <br /> a . generate objectional odors : No <br /> b. generate any discharge 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 <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 /> �x Legal Property Owner (owner includes partner, trustee, trustor , or <br /> corporate officer . ) <br /> �--I 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 /> (Si nature ) (Date ) <br /> Minor Subdivision - 10 - ( 6/86 ) <br />