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5 . Will the project: <br /> a . generate objectional odors : \T <br /> b. generate any discharge into surface waters :_ 5/A <br /> C . generate or store hazardous materials: <br /> N/A <br /> d. expose people to any hazardous materials cd situations: <br /> e. displace people: N/A <br /> f . use significant amounts of energy or natural resources : N/A <br /> g . cause congestion on roadwav , or at interc <br /> tons: N/A r <br /> hanges or intes <br /> O SIGNATURE <br /> Z certify under enalty F -r-, dt - <br /> _. p c_ peri �.aa,, l ��__ (check one ) : <br /> Legal property Owner (oume inc x� c �.rtn � t,� <br /> corporate officer . ) p ,,=tee, trustor, or <br /> Owner 's agent legal a , �� � __. <br /> e g g (a}bea'c Pe o� the acrner's consent to file <br /> the appli- --on ) , <br /> and that / e foregei ng is truc-. an` correct. <br /> (Signature) - <br /> _ (Date ) <br />