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5 . Will the project: <br /> a . generate objectional odors : No <br /> b. generate any discharge into surface waters : No <br /> C . generate or store hazardous materials : No <br /> d. expose people to any hazardous materials or situations: No <br /> e . displace people: 2 small residences are expected to be removecLc ( ser- <br /> e . <br /> f . use significant amounts of energy or natural resources : No �rr <br /> Live ) <br /> g. cause congestion on roadways or at interchanges or intersec- <br /> tions: No <br /> ❑ SIGNATURE <br /> I certify under penalty of perjury that I am (check one ) : <br /> X❑ Legal Property Owner (owner includes partner, trustee, trustor, or <br /> corporate officer . ) <br /> UOwner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and that the forg ing is true and correct. <br /> Y11,��4 <br /> (Signature ) (Date ) <br /> Laurie Edwards Brown <br /> (Signa ure ) (Date <br /> oan Devon Brown <br /> Minor Subdivision - 10 - ( 6/86 ) <br />