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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 /> O SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> OLegal Property Owner (owner includes partner, trustee, trustor, or <br /> corporate officer . ) <br /> uOwner '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 /> -/ i (S 'gnature ) (Date ) <br /> Minor Subdivision - 10 - (6/86 ) <br />