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5 . Will the project : "� <br /> a . generate objectional odors : A)O <br /> b. generate any discharge into surface waters : <br /> c . generate or store hazardous materials: A-Ap <br /> d. expose people to any hazardous materials or situations: ;Vi— <br /> e . displace people: A)a <br /> f . use significant amounts of energy or natural resources: <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions: A)f <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> Legal Property Owner (owner includes partner, trustee, trustor, or <br /> corporate officer . ) <br /> LJ Owner 's legal agent (attach proof of the owner 's consent to file <br /> the application ) , <br /> and that the f. egoing is true and correct . <br /> AJ 611 F e-,-A <br /> L- gnature ) (Date ) <br /> Minor Subdivision - 10 - ( 6/86 ) <br />