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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 : ' r, <br /> d. expose people to any hazoFf <br /> rdous mat ials or situations: ,= <br /> e . displace people : <br /> �,� <br /> f . use significant amounts energ o natural resources : <br /> g. cause congestion on roadways o 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 /> �---! Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , /J <br /> and that the fo egoing i ' true and correct. <br /> 4,7 <br /> gig'nat fe} (Date ) <br /> { <br /> Vse Permit Application - 10 - ( 6/86 ) <br />