1.  Any timber owner whose timberland is to be devoted to any use other than the growing of timber shall file an application for a timberland conversion certificate with the State Forester Firewarden.

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2.  Such application shall be on a form prescribed by the State Forester Firewarden and shall include the following information:

(a) The name of the timber owner and his or her address.

(b) The legal description of the land to be converted.

(c) The approximate number of acres to be converted.