At a minimum, the following general administrative information must be provided for a proposed subdivision for which groundwater under the land will be the source of water supply:(1) the name of the proposed subdivision;(2) any previous or other name(s) which identifies the tract of land;(3) the name, address, phone number, email address, and facsimile number of the property owner or owners;(4) the name, address, phone number, email address, and facsimile number of the person submitting the plat application;(5) the name, address, phone number, email address, facsimile number, and registration number of the licensed professional engineer or the licensed professional geoscientist preparing the certification as required in this chapter;(6) the location and property description of the proposed subdivision;(7) the tax assessor parcel number(s) by book, map, and parcel; and(8) the name, address phone number, email address, and facsimile number of the applicable groundwater conservation district or districts.