An application for a permit shall be made on forms furnished by the building department and shall contain such information as the department may require, including, but not limited to:

    A.     A plot plan accurately showing the location of the well with respect to the following items, within a radius of one hundred fifty feet from the well:

    1.    Property lines and easements on the property;   

    2.    Sewage disposal systems or works carrying or containing sewage;   

    3.    All intermittent or perennial, natural or artificial bodies of water or water courses;

    4.    The approximate drainage pattern of the property;  

    5.    Buildings;  

    6.    Other wells;  

    7.    Width of abutting roads.  

    B.    The location of the property.

    C.    The name of the person or contractor who will construct the well.

    D.    The irrigation uses to which the well water will be utilized.

    E.    Other information as may be necessary to determine if underground waters will be adequately protected. (Prior code § 23-38)