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/23428/2017   (ii). Name of Project for which Forest Land is required : upgradation to 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 : Preparation Details Project Report for Upgradation Junction with NH-27 near Dhoraji-Jamkandorna-Kalavad section of NH-927D in the State of Gujarat to two/four lane with Pavedshoulder configuration(Package no-NH/IAHE/18)   (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) : 23100   (viii). Area of forest land proposed for diversion(in ha.): 32.9717   (ix). Non-forest land required for this project(in ha.): 2   (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.Jamnagar32.97172
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Jamnagar32.97172
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.)
1Km72.200 to KM 64.29711.2617752
2Km.64.202 to 64.1400.088350
3Km 64.023 to 51.00018.5577750
4km 51.000 to km 48.8503.063750
C. Maps of forest land proposed to be diverted
Division 1. : Jamnagar
  (i). Area of forest land proposed to be diverted(in ha.) : 32.9717   (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).
1.32.9717    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 Diversion of Forest Land comprises road side p
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
1Part-1 by User Agency
2Diversion of Area( road side strip plantation)as PF
3Undertaking of NPV
4Undertaking of CA
5Undertaking of Additional NPV
6REG. FLY ASH
7Request letter has been sent to CollectorJamnagr attached reg,FRA-2006
8alternate soption
9justification used forest land
10Project Brief
11Executive Summary of the Project
12Line diagram showing the protected Forest Area 72+200 to 48+850 coming in Jamnaga r district of NH-927d as road side strip plantation of Trees as PF
13Georeference Map
14Authority letter
15FRA CERTIFICATES ISSUED BY COLLECTOR JAMNAGAR
16Registration and Processing fees