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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 : 111p <br /> d. expose people to any hazardous materials or situations: <br /> e. displace people: IVO <br /> f . use significant amounts of energy or natural resources : /(/:) <br /> g . cause congestion on roadways or at interchanges or intersec- <br /> tions: NU <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 ) , <br /> a that the foregoing is true and correct. <br /> (Signature ) (Date ) <br /> Use Permit Application - 10 - (6/86 ) <br />