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5 . Will the project: <br /> a . generate objectional odors : /�p <br /> b. generate any discharge into surface waters : <br /> C . generate or store hazardous materials : N n <br /> d. expose people to any hazardous materials or ' situations : N o <br /> e . displace people: No <br /> f . use significant amounts of energy or natural resources : d <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions: __ p <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 /> LJOwner 's legal agent (attach proof of the owner 's consent to file <br /> the application ), <br /> an at the fo a oing is true and correct. <br /> ( ignature ) ( te ) ' <br /> Minor Subdivision - 10 - ( 6/86 ) <br />