A. Application for a permit required by Section 13.16.080 shall be made to the health officer. Such application shall be on forms furnished by the health officer and shall provide all information pertaining to the project required by the health officer. Every application shall be signed by the owner or lessee of the land on which the well is, or will be, located, or the owner of the easement which allows the con-struction of a well, or the authorized agent of any such person.
B. The following information shall be furnished:
1. Owner's name and address;
2. Intended use of well, whether domestic, agricultural, industrial, or other use;
3. Location of well by reference to street address, nearest streets or cross roads or other significant features and, when requested by the health officer, by reference to township, range and section;
4. Dimensioned plot plan indicating north direction, distances and location of existing and proposed structures, sewers or sewage disposal systems, other wells and any other potential source of contamination or pollution on the property or adjacent property within one hundred fifty (150) feet of the well or proposed well;
5. Well drilling contractor's name, address and contractor's license number;
6. Nature of the work to be done, whether construction, deepening or other work, and the method to be used, whether cable tool, rotary or other method;
7. Estimated depth of well when completed;
8. Size, gauge and type of casing;
9. Significant features of well (e.g., conductor casing or gravel pack).
C. In addition to the foregoing the health officer may require such other and further information relevant to the project as he may deem necessary to determine whether the public health and safety require the denial of the permit or the imposition of further conditions.
D. A permit may be denied for failure to supply any information required by or pursuant to this section which is known to, or by the exercise of reasonable diligence can be acquired by, the applicant. (Prior code § 7769)