No person, unless expressly exempted by a specific management regulation of the department adopted for an area or subarea, may withdraw any artificially stored groundwaters for beneficial use from any area, subarea, or zone without first obtaining a permit from the department of ecology as hereinafter provided. An application for a permit shall be submitted on a form provided by the department. The application shall contain the following information:

(1) Name

(2) Address

(3) Point of withdrawal

(4) Place of use

(5) Purpose of use

(6) Time of use

(6a) Amounts of withdrawal, including both maximum rate and the total volume each calendar year

(7) The area, subarea, and zone from which the waters are to be withdrawn.