(a) The names of any adjacent subdivision;

(b) A vicinity map;

(c) Lines marking the boundaries of proposed lots, square footages of the proposed lots and number of each lot;

(d) Approximate locations of existing roads, cul-de-sacs, alleys and ways or easements for such roads, and rights-of-way within and adjacent to the tract;

(e) Location, dimensions and usage designations for all proposed and existing easements of record;

(f) Proposed source of water supply and method of sewage disposal for each lot;

(g) The legal description and parcel number of the said tract;

(h) The name and address of the owner or owners of the said tract;

(i) A completed environmental checklist form;

(j) Land surveyor certificate;

(k) Signatures of all recorded property owners agreeing to the division of property;

(l) A utility easement and improvement statement shall be shown on the face of the short plat in a manner prescribed by the appropriate utility provider;

(m) The signature block shall include the following: