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5 . Will the project : <br /> a . generate objectional odors : A)J <br /> b. generate any discharge into surface waters : d <br /> c . generate or store hazardous materials: AA& <br /> d. expose people to any hazardous materials or situations : v <br /> e . displace people: A0 <br /> f . use significant amounts of energy or natural resources : A14 <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions: A/• <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 oregoing is true and correct. <br /> (Signat r ) (Date ) <br /> Minor Subdivision - 10 - ( 6/86 ) <br />