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5,. Will the project: <br />a. generate objectional odors: to <br />b. generate any discharge into surface waters: p <br />c. generate or store hazardous materials: iub <br />d. expose people to any hazardous materials or situations:tlr <br />e. displace people: G <br />f. use significant amounts of energy or natural resources: o <br />g. cause congestion on roadways or at interchanges or intersec- <br />tions: -�o <br />O 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 />�J Owner's legal agent (attach proof of the owner's consent to file <br />the application), <br />and that the foregoo�n tr and correct. <br />r Z4A- 1-LNDAA2L'i� �� / <br />(Signature) (Date) <br />Major Subdivision - 10 - (6/86) <br />