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/GJ/ROAD/23139/2016   (ii). Name of Project for which Forest Land is required : Two/Four laning of Dhoraji-Jamkandorna-Kalavad section of NH-927D in the State of Gujarat.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Two/four lanewith paved shoulder of Dhoraji-Jamkandorna-Kalavad section of NH-927D from km 107.500 to km 48.850(Package-1) in State of Gujarat   (iv). State : Gujarat   (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) : 21300   (viii). Area of forest land proposed for diversion(in ha.): 68.7893   (ix). Non-forest land required for this project(in ha.): 9.7208   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : EXECUTIVE ENGINEER NATIONAL HIGHWAY DIVISION   (ii). Address1 : Office of the Executive Engineer, National Highway Division, Dr. Rajendr Prasad Road, Rajkot   (iii). Address2 : NIL   (iv). State : Gujarat   (v). District : Rajkot   (vi). Pin : 360001   (vii). Landmark : Nr. Kashi Vishvanath Temple   (viii). Email address : eenhdivisionrajkot@gmail.com   (ix). Landline Telephone No. : 281-2446605   (x). Fax No. : 281-   (xi). Mobile No. : 9409302980   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Ravindra Narayan   (ii). Middle Name: Shiv Narayan   (iii). Last Name: Mathur   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Office of the Executive Engineer, National Highway Division, Dr. Rajendra Prasad Road, Rajkot   (vii). Address 2: NIL   (viii). State: Gujarat   (ix). District: Rajkot   (x). Tehsil: Rajkot   (xi). Pin: 360001   (xii). Landmark: Nr. Kashi Vishvanath Temple   (xiii). Email Address: eenhdivisionrajkot@gmail.com   (xiv). Landline Telephone No.: 281-2446605   (xv). Fax No.: NIL   (xvi). Mobile No.: 9409302980   (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.Rajkot68.78939.7208
Total68.78939.7208
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Rajkot68.78939.7208
1.Jamnagar00
Total68.78939.7208
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
NIL
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1km 72.200 to 80.60017.019.7208
2km80.800 to km 81.2200.85050
3KM 82.000 to km100.84038.1510
4km 100.840 to km 101.540(in this portion due to i0.708750
5from km 101.540 to 107.50012.0690
Total 68.78925 9.7208
C. Maps of forest land proposed to be diverted
Division 1. : Rajkot
  (i). Area of forest land proposed to be diverted(in ha.) : 68.7893   (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).
1.68.7893    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 existing road has to developed as 2/4lane with
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 0   (iii). Temporary Employment(Number of person-days): 3000
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? : Yes   (a). Copy of documentry evidence in support of settlement of rights under the Forest Rights Act,2006 on the forest land proposed to be diverted:
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: Linear or 'strip' plantation declared as protected forest along with road/rail/canal sides for widening or expansion of road/rail/canal
Additional information Details
Documents
S.No Documents
Remarks
1FRA CERTIFICATES ISSUED BY COLLECTOR TAJKOT
2FORM-A Part-1
3UNDERTAKING OF NPV
4UNDERTAKING OF CA
5UNDERTAKING OF ADD NPV
6PROJECT BRIEF
7DGPS MAP
8EXECUTIVE SUMMARY
9TRAFFICE DATA
10FOREST AREA
11FOREST AREA IN FORMAT
12USED OF FLY ASH
13JUSTIFICATION
14FRA-CERTIFICATE-UNDER PROCESS
15Enviroment Clearnce
16Administrative APPROVAL
17Georefrence map
18Georefrence map
19
20replied letter