FORM - A
Form for seeking prior approval of Central Government under section 2 of the Forest(Conservation) Act,1980 for Diversion of fresh forest area
PART - I
(To be filled up by User Agency)
A. General Details
A-1. Project Details
  (i). Proposal No. : FP/GA/TRANS/35112/2018   (ii). Name of Project for which Forest Land is required : Xeldem- Xeldem (Existing) 220 kV HTLS D/C Transmission Line   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of Forest land for Construction of Xeldem- Xeldem (Existing) 220 kV HTLS D/C Transmission Line under North Goa Forest Division and South Goa Forest Division in Goa State.   (iv). State : Goa   (v). Category of the Proposal : Transmission Line   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 382.5   (viii). Area of forest land proposed for diversion(in ha.): 28.24   (ix). Non-forest land required for this project(in ha.): 43.444   (x). Total period for which the forest land is proposed to be diverted(in years): 35
A-2. Details of User Agency
  (i). Name : GOA TAMNAR TRANSMISSION PROJECT LIMITED   (ii). Address1 : F1 Mira Corporate Suite, Main Mathura Road, Ishwar Nagar,New Delhi-110065   (iii). Address2 : NIL   (iv). State : Delhi   (v). District : South   (vi). Pin : 110065   (vii). Landmark : Okhla Raiway Station   (viii). Email address : nitin.agrawal@sterlite.com   (ix). Landline Telephone No. : 11-49962227   (x). Fax No. : 11-   (xi). Mobile No. : 9717991096   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Nitin   (ii). Middle Name: NIL   (iii). Last Name: Agrawal   (iv). Gender: Male   (v). Designation: Manager   (vi). Address 1: F1 Mira Corporate Suites, Main Mathura Road, Ishwar Nagar, New Delhi-110065   (vii). Address 2: NIL   (viii). State: Delhi   (ix). District: South   (x). Tehsil: Kalkaji   (xi). Pin: 110065   (xii). Landmark: Okhla Railway Station   (xiii). Email Address: nitin.agrawal@sterlite.com   (xiv). Landline Telephone No.: 11-49962227   (xv). Fax No.: NIL   (xvi). Mobile No.: 8208007975   (xvii). Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency:
B. Details of land required for the Project
B-1. Details of proposal seeking prior approval of Central Government under the Act for diversion of forest land for the Project already submitted in the past
List of proposal submitted in Past
S.no Proposal Status. Proposal No. Moef File No. Area Proposed for Diversion(Ha.) Area Diverted(Ha.) Date of In-Principle Approval Date of Final Approval
NIL
B-2. Details of forest land proposed to be diverted
B-2.1 Details of Divisions involved
Details of Divisions involved
S.no Division Name Forest Land(ha.) Non-Forest Land(ha.)
1.North5.088.382
2.South23.1635.062
Total28.2443.444
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.South Goa28.2443.444
Total28.2443.444
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Sanvordem,Rumbrem, Bandoli,Codli, Cormonem, Sangod28.2443.444
Total 28.24 43.444
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Transmission line corridor28.23843.435
Total 28.238 43.435
C. Maps of forest land proposed to be diverted
Division 1. : South
  (i). Area of forest land proposed to be diverted(in ha.) : 23.16   (ii). Nature of the Project: Linear   (b). No. of Segments : Five
Segment wise details
Segments Segment Area(in ha.) Kml File of Segments
(To view KML file on google the same may be downloaded and then open if in google earth install in your computer).
1.7.81    View File
2.7.68    View File
3.0.99    View File
4.3.74    View File
5.2.94    View File
  (iii). Copy of Survey of India Toposheet indicating boundary of forest land proposed to be diverted:   (iv). Scanned copy of the Geo-referenced map of the forest land proposed to be diverted prepared by using GPS or Total Station:
Division 2. : North
  (i). Area of forest land proposed to be diverted(in ha.) : 5.08   (ii). Nature of the Project: Linear   (b). No. of Segments : One
Segment wise details
Segments Segment Area(in ha.) Kml File of Segments
(To view KML file on google the same may be downloaded and then open if in google earth install in your computer).
1.5.08    View File
  (iii). Copy of Survey of India Toposheet indicating boundary of forest land proposed to be diverted:   (iv). Scanned copy of the Geo-referenced map of the forest land proposed to be diverted prepared by using GPS or Total Station:
D. Justification for locating the Project in forest land and details of alternatives examined:
  (i). Copy of note containing justification for locating the Project in forest land:   (ii). Whether a copy of map indicating location of alternative examine is required to be provided: Yes   (a). Copy of map indicating location of alternative examined:
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 36   (iii). Temporary Employment(Number of person-days): 12600
F. Displacement of People due to the Project, if any
  (i). Whether Project involves displacement?: No
G. Details of Cost-Benefit analysis for the Project
  (i). Whether the Project requires Cost-Benefit analysis?: Yes   (a). Copy of Cost-Benefit analysis:
H. Status of Environmental Clearance
  (i). Whether the Project requires Clearance under the Environment (Protection) Act 1986 ? : No
I. Status of Wildelife Clearance
  (i). Whether the Project or a part thereof is located in any Protected Area or their Eco sensitive zone? : No
J. Applicability of special provisions governing Scheduled Areas
  (i).Whether the Project or a part thereof is located in a Scheduled Area? : No
K. Status of settlement of rights under the Forest Rights Act,2006 on the forest land proposed to be diverted
  (i). Whether the process for settlement of Rights under the Forest Rights Acts 2006 on the forest land proposed to be diverted has been completed? : No
L. Details of land identified for Compensatory Afforestation
  (i). Whether non-forest or Revenue forest land is required to be provided by User Agency?: No   (ii). Whether the area of non-forest land or Revenue forest land required to be provided by User Agency for raising Compensatory Afforestation is less than area of forest land proposed to be diverted ?: No   (iii) . Reason for not providing Non-Forest Land: For laying of transmission lines
Additional information Details
Documents
S.No Documents
Remarks
1Order of Work or Letter of Intent from PFC
2Section 68 approval from Ministry of Power
3Form I & XIV of Govt Forest
4Form I & XIV of Private Forest
5Cost Benefit Analysis
6Village Map of South Goa Division
7Brief Note on Project and justification
8Project Layout Plan
9Certificate for minimum use of forest land
10Certificate that project does not effect any monuments of historical archaeological or any religious place
11Certificate for non voilation of Forest Conservation Act
12Details of transmission line length, width passing through forest and non forest area
13Statement showing details of Forest Area
14Statement showing details of non Forest Area
15Undertaking for Compensatory afforestation
16Undertaking for NPV
17Undertaking regarding establishment of labour camp
18Undertaking for dwarf PLantation
19Undertaking for FRA
20Reply of EDS against the additional details sought by DCF-North Goa
21EDS reply regarding correction in forest area