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/38900/2019   (ii). Name of Project for which Forest Land is required : Construction of Eight lane road (newly declared NH 148N) from Kajaliya village in Ratlam district in the state of Madhya Pradesh to Dodka village in Vadodara district in the state of Gujarat from CH:   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The proposed expressway is mostly green field project and proposed for eight lane (newly declared NH 148N) from Kajaliya village in Ratlam district in the state of Madhya Pradesh to Dodka village in Vadodara district in the state of Gujarat from CH: 181+000 to 392+492. The project road starts from K   (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) : 634500   (viii). Area of forest land proposed for diversion(in ha.): 2.9993   (ix). Non-forest land required for this project(in ha.): 414.9484   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : National Highways Authority of India   (ii). Address1 : 13, Haidary Society, Civil lines road, Godhra   (iii). Address2 : NIL   (iv). State : Gujarat   (v). District : Panchmahal   (vi). Pin : 389001   (vii). Landmark : Opp. Gymkhana   (viii). Email address : piugodhra@nhai.org   (ix). Landline Telephone No. : 2672-252401   (x). Fax No. : 2672-252402   (xi). Mobile No. : 8527322881   (xii). Website (if any) : www.nhai.org   (xiii). Legal status of User Agency : Central PSU
A-3. Details of Person Making Application
  (i). First Name: Zafar   (ii). Middle Name: Ahmad   (iii). Last Name: Sultani   (iv). Gender: Male   (v). Designation: PD   (vi). Address 1: 13, Haidary society, civil lines road, Godhra   (vii). Address 2: NIL   (viii). State: Gujarat   (ix). District: Panchmahal   (x). Tehsil: Godhra   (xi). Pin: 389001   (xii). Landmark: Opp. Gymkhana   (xiii). Email Address: piugodhra@nhai.org   (xiv). Landline Telephone No.: 2672-252401   (xv). Fax No.: 02672252402   (xvi). Mobile No.: 8527322881   (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.Vadodara SF2.9993414.9484
Total2.9993414.9484
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Vadodara2.9993414.9484
Total2.9993414.9484
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1NAVERIYA0.115236.1606
2KAMBOLA06.4636
3MAL ANKALIYA VILLAGE0.422230.9223
4RANIPURA VILLAGE0.295828.3399
5NANI BHADOL022.8272
6GANGADIYA VILLAGE0.15212.9859
7PRATAP NAGAR VILLAGE0.491723.3588
8SAMLYA05.7293
9MOTIPURA016.2555
10PASVA VILLAGE0.659916.8781
11SUBHELAV VILLAGE0.148832.5884
12PALDI027.7418
13TUNDAV VILLAGE0.27239.9194
14MANJUSAR01.8
15ANJESAR0.056110.2356
16MOKSHI0.263836.6611
17DODAKA0.121866.0809
Total 2.9993 414.9484
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1ROAD2.9993414.9484
Total 2.9993 414.9484
C. Maps of forest land proposed to be diverted
Division 1. : Vadodara SF
  (i). Area of forest land proposed to be diverted(in ha.) : 2.9993   (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).
1.2.9993    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): 50   (iii). Temporary Employment(Number of person-days): 300
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 ? : Yes   (a). Status of the Environmental Clearance to the Project: EC under process   (ii). Environmental Clearance File No.: 10-50/2018-IA.III
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?: Not Applicable   (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: Not Applicable
Additional information Details
Documents
S.No Documents
Remarks
1Alternative Alignment Option Study
2UNDERTAKING FOR MINIMUM USE OF FOREST,CA,NPV
3Khasra map of vadodara
4VILLAGE WISE FOREST AND NON-FOREST AREA VADODARA
5GAZETTE NOTIFICATION OF MoRTH
6TCS DETAIL
7FRA GUIDELINES FOR LINEAR PROJECT
8EDS REPLY OF 26 MARCH 2019 BY NODAL OFFICER, VADODARA, GUJARAT
9VILLAGE WISE FOREST AREA DETAIL VADODARA