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/65531/2020   (ii). Name of Project for which Forest Land is required : Netravali UG cabling work   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : This project involves the work of conversion of existing 11KV overhead Netravali feeder to 11KV U/G cabling network emanating from 33/11KV Vaddem substation in Sanguem constituency under the jurisdiction of Elect. Sub Division-III, Sanguem. The existing 11KV HT overhead line of Netravali Feeder feed   (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) : 4526.74579   (viii). Area of forest land proposed for diversion(in ha.): 1.01793   (ix). Non-forest land required for this project(in ha.): 4.02736   (x). Total period for which the forest land is proposed to be diverted(in years): NIL
A-2. Details of User Agency
  (i). Name : GOA ELECTRICITY DEPARTMENT   (ii). Address1 : O/o Executive Engineer, Electricity Department Opp cada Hall   (iii). Address2 : NIL   (iv). State : Goa   (v). District : South Goa   (vi). Pin : 403706   (vii). Landmark : Opposite Cada Hall   (viii). Email address : ee7-elec.goa@nic.in   (ix). Landline Telephone No. : 832-2650632   (x). Fax No. : 832-   (xi). Mobile No. : 8380015007   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Vinayak   (ii). Middle Name: NIL   (iii). Last Name: Mhalsekar   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: O/o Executive Engineer, Electricity Department Opp cada Hall   (vii). Address 2: NIL   (viii). State: Goa   (ix). District: South Goa   (x). Tehsil: Quepem   (xi). Pin: 403706   (xii). Landmark: Opposite Cada Hall   (xiii). Email Address: ee7-elec.goa@nic.in   (xiv). Landline Telephone No.: 832-2650632   (xv). Fax No.: NIL   (xvi). Mobile No.: 8380015007   (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.Wildlife - South1.017934.02736
Total1.017934.02736
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.South Goa1.017934.02736
Total1.017934.02736
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Verlem0.495170.10914
2Netravali0.421841.69889
3Mangal0.082920.36389
4Nundem0.0180.1757
5Curpem00.80388
6Vichundrem00.33772
7Colomba00.32122
8Rivona00.21692
Total 1.01793 4.02736
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
111.017423.88164
220.000505750.00267
3300.14305
Total 1.01792575 4.02736
C. Maps of forest land proposed to be diverted
Division 1. : Wildlife - South
  (i). Area of forest land proposed to be diverted(in ha.) : 1.01793   (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).
1.1.01793    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: The villages like verlem, Tudou, Netravali etc. ar
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: No
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? : Yes   (a). Whether Project or a part thereof is located within a Protected Area ? : Yes   (b). Status of approval of the Supreme Court : Application yet to b   (ii). Status of approval of the Standing Committee of National Board for the Wildlife(NBWL) to the Project : Application yet to be submitted
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: For laying of transmission lines
Additional information Details
Documents
S.No Documents
Remarks
1Brief Note
2Certificate for non violation of FCA 1980
3Certificate for the proposal does not affect any monuments
4form three 3 bar 5
5form three 3 bar 1
6form three 3 bar 3 and 3 bar 4
7form three 4 bar 1
8form three 6 bar 1
9form three 8 bar 2
10form three 18 bar 1
11form three 19 bar 1 and 20 bar 1
12form three 34 bar 1
13Village Map of Netravali
14Administrative approval to the work
15Work Order
16Corrigendum to WO
17Project details
18certificate for minimum use of forest land
19statement showing details of forest area proposed for diversion
20statement showing details of non forest area proposed for diversion
21undertaking for payment of CA
22undertaking for payment of NPV
23Survey plan Netravali and Verlem
24Village map Verlem
25Coordinates map
26Survey plan 15 Mangal
27Survey plan 29 Nundem
28Survey plan 21 Mangal
29Survey plan 20 Mangal
30Survey plan 17 Mangal
31Survey plan Mangal and Nundem
32Toposheet Mangal and Nundem
33Nundem 29 1 form one and fourteen
34Mangal 13 1 form one and fourteen
35Mangal 13 2 form one and fourteen
36Mangal 13 6 form one and fourteen
37Mangal 15 1 form one and fourteen
38Mangal 15 2 form one and fourteen
39Mangal 17 1 form one and fourteen
40Mangal 18 1 form one and fourteen
41Mangal 20 1 form one and fourteen
42Mangal 21 1 form one and fourteen
43Mangal 18 2 form one and fourteen
44Survey plan 18 1 2 Mangal
45Survey plan 13 1 2 6 Mangal
46Verlem 9 1 form one and fourteen
47Netravali 146 1 form one and fourteen
48Netravali 139 1 form one and fourteen
49Netravali 133 1 form one and fourteen
50Netravali 109 1 form one and fourteen