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5. Will the project: <br /> a . generate objectional odors : <br /> b. generate any discharge into surface waters: <br /> c. generate or store hazardous materials: 4C, <br /> d. expose people to any hazardous materials or situations: <br /> e. displace people: a%// <br /> f. use significant amounts of energy or natural resources: <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions: +�!� <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 /> 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 <br /> TVgn-a-Eure ) (Date ) , <br /> 1 <br /> Minor Subdivision - 10 - (6/86 ) <br />