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5 . Will the project: I <br /> a . generate objectional odors : tdy A <br /> b. generate any discharge into surface waters : <br /> C . generate or store hazardous materials : NJ A- � <br /> d. expose people to any hazardous materials or situations. N1 <br /> e . displace people: N IA <br /> f . use significant amounts of energy or natural resources : tv/A <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions: N.1 A <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 . ) Ii <br /> U Owner 's legal agent (attach proof of the owner 's consent to file I <br /> the application ) , <br /> and that the foregoing is true and correct . <br /> (hSign re ) �— (Date ) T� <br /> Minor Subdivision - 10 - ( 6/86 ) <br />