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5 . Will the project: <br /> a . generate objectional odors : tlO <br /> b. generate any discharge into surface waters : fir, <br /> c . generate or store hazardous materials : 'N <br /> d. expose people to any hazardous materials or situations: <br /> e . displace people : Q0 <br /> f . use significant amounts of energy or natural resources : o <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 /> 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 the foregoing is true and correct. <br /> (Signature ) (Date ) c <br /> Minor Subdivision - l0 - ( 6/86 ) <br />