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/CG/ROAD/39866/2019   (ii). Name of Project for which Forest Land is required : Construction of Raigarh - Hamirpur Road (MDR)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of Raigarh - Hamirpur Road (MDR)- Strengthening and widening of existing PWD road passing through Forest patches. Diversion of forest land for non-forest use under FCA 1980   (iv). State : Chhattisgarh   (v). Category of the Proposal : Road   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 5129   (viii). Area of forest land proposed for diversion(in ha.): 17.523   (ix). Non-forest land required for this project(in ha.): 8.965   (x). Total period for which the forest land is proposed to be diverted(in years): NIL
A-2. Details of User Agency
  (i). Name : EE RAIGARH JAMGAON ROAD PWD RAIGARH   (ii). Address1 : EXECUTIVE ENGINEER, P.W.D. RAIGARH DIVISION   (iii). Address2 : RAIGARH   (iv). State : Chhattisgarh   (v). District : Raigarh   (vi). Pin : 496001   (vii). Landmark : NIL   (viii). Email address : ee.raigarh@nic.in   (ix). Landline Telephone No. : 7762-220417   (x). Fax No. : 7762-   (xi). Mobile No. : 9424200944   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Ravidra   (ii). Middle Name: Kumar   (iii). Last Name: Khambra   (iv). Gender: Male   (v). Designation: EE   (vi). Address 1: Near polytechnic college Raigarh CG   (vii). Address 2: NIL   (viii). State: Chhattisgarh   (ix). District: Raigarh   (x). Tehsil: Raigarh   (xi). Pin: 496001   (xii). Landmark: NIL   (xiii). Email Address: sdopwd7@gmail.com   (xiv). Landline Telephone No.: 7762-220417   (xv). Fax No.: 07762220417   (xvi). Mobile No.: 8224896000   (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.Raigarh17.5238.965
Total17.5238.965
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Raigarh17.5238.965
Total17.5238.965
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Sambalpuri03.556
2Nawagaoun00.831
3Bagursiya01.638
4Joboro00.469
5Pali00.16
6Hamirpur01.296
7Chakradharpur(Masati village)01.015
8RF 967 (Vijaypur)3.3150
9RF 966 (Vijaypur)0.1910
10RF 968 (Tarpali)0.1710
11PF 949 (Sambalpuri)0.9880
12RF 927 (Bangursiya)0.5350
13PF 941 (Bangursiya)0.3140
14RF 909 (Nawagaon)0.9440
15RF 919 (Karmagarh)2.6980
16RF 913 (Parigaon)1.8390
17RF 917 (Karmagarh)0.2830
18RF 916 (Bangursiya)0.4970
19RF 914 (Parigaon)3.3610
20Sambalpuri 251/10.0440
21Sambalpuri 2540.2070
22Sambalpuri 242/10.1060
23Sambalpuri 107/10.2890
24Sambalpuri 1060.3270
25Sambalpuri 1160.0440
26Bangursiya 340.0140
27Nawagaon 1260.1510
28Joboro 329/1ka0.0150
29Hamirpur 178/2,180/40.4950
30Hamirpur 18/2 Ka0.5920
31Hamirpur 18/2 Jha0.0450
32Hamirpur 18/2 J0.0570
Total 17.522 8.965
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Strengthening and Widening of PWD Road17.5238.965
Total 17.523 8.965
C. Maps of forest land proposed to be diverted
Division 1. : Raigarh
  (i). Area of forest land proposed to be diverted(in ha.) : 17.523   (ii). Nature of the Project: Linear   (b). No. of Segments : Two
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).
1.15.137    View File
2.2.386    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: No   (a). Reason for not providing such map: It is strengthening and widening of existing road
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 100   (iii). Temporary Employment(Number of person-days): 200
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?: No
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? : Yes
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 ?: Not Applicable   (iii) . Reason for not providing Non-Forest Land: Central Govt. Project
Additional information Details
Documents
S.No Documents
Remarks
1DD Submission Fee Letter
2DGPS Certified Report
3Area Statement- Forest and Non Forest
4Revenue Forest NOC Application
5FRA Application to District Collector
6Road Alignment on Cadastral maps
7Ministry of Roads and Transport Letter - Sanction for strengthening and Widening of Raigarh Hamipur Road