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5 . Will the project: <br /> a . generate objectional odors : ND <br /> b. generate any discharge into surface waters : N <br /> C . generate or store hazardous materials : WO <br /> d. expose people to any hazardous materials or situations :�Q_ <br /> e . displace people:_ NO <br /> f . use significant amounts of energy or natural resources :�a <br /> g . cause congestion on roadways or at interchanges or intersec- <br /> tions : N O <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 /> E— Owner ' s legal agent (attach proof of the owner ' s consent to file <br /> the application ) , <br /> and that the fo egoing is true and correct. <br /> 1-C[- <br /> ( ig ature ) (Date ) <br /> Minot Subdivision - 10 - ( 6/86 ) <br />