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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 : Typical Home/Farm Chemical & <br /> d. expose people to any hazardous materials or situations : Situatioi <br /> e . displace people : Noawe as above <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 /> ❑ 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 /> l =1 Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> a that toe foregoing is true and correct . <br /> (/Date ) <br /> Minor Subdivision - 10 - ( 6/86 ) <br />