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/HP/Others/155676/2022   (ii). Name of Project for which Forest Land is required : Construction of Panchwati at Bakhrunda GP Kelodhar   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : This HP Panchvati Scheme will enhance the life expectancy of elderly people keeping in view health requirements of the senior citizens. Several ayurvedic and medicinal plants would be grown in the parks and gardens along with recreational equipment, walking tracks and other basic amenities for senio   (iv). State : Himachal Pradesh   (v). Category of the Proposal : Others   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 55   (viii). Area of forest land proposed for diversion(in ha.): 0.73   (ix). Non-forest land required for this project(in ha.): 0   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : HIMACHAL PRADESH RURAL DEVELOPMEN AND PANCHAYATI RAJ DEPARTMENT   (ii). Address1 : Directorate of Rural Development & Panchayati Raj Department of Himachal Pradesh, Block No-27, SDA Complex Kasumpti, Shimla-9   (iii). Address2 : NIL   (iv). State : Himachal Pradesh   (v). District : Mandi   (vi). Pin : 171009   (vii). Landmark : NIL   (viii). Email address : panchayatiraj-hp@gov.in   (ix). Landline Telephone No. : 91-0177-2623805   (x). Fax No. : 91-   (xi). Mobile No. : 8219738696   (xii). Website (if any) : //rural.hp.gov.in   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Sutinder   (ii). Middle Name: nil   (iii). Last Name: Thakur   (iv). Gender: NIL   (v). Designation: Block Development Officer   (vi). Address 1: BLOCK DEVELOPMENT OFFICER, DEVELOPMENT BLOCK KARSOG, DISTRICT MANDI H.P.   (vii). Address 2: NIL   (viii). State: Himachal Pradesh   (ix). District: Mandi   (x). Tehsil: NIL   (xi). Pin: 175011   (xii). Landmark: NIL   (xiii). Email Address: piakarsog@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 9418100822   (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.Karsog0.730
Total0.730
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Mandi0.730
Total0.730
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1DPF Suranda0.590
2Bakhrunda0.140
Total 0.73 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1PLAY AREA0.180
2PATHWAYS0.170
3PARK/SITTING AREA0.170
4OAT (OPEN AIR THEATRE )0.050
5CYCLONE SHELTER0.010
6WATER BODY/FOUNTAIN0.030
7KITCHEN AREA0.010
8SERVICE AREA0.020
9HERBAL GARDEN0.030
10PARKING AREA0.050
11TOILETS0.010
Total 0.73 0
C. Maps of forest land proposed to be diverted
Division 1. : Karsog
  (i). Area of forest land proposed to be diverted(in ha.) : 0.73   (ii). Nature of the Project: Non Linear   (a). No. of patches : One
Patch wise details
Patch No. Area of Patch(in ha.) Kml File of PatchesTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0.73    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:
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): 16258
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? : 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
1Part-I (Form No A)
2Detail Note on the Project CL-4
3Population Benefited Certificate
4Check List No-7
5Check List No-8
6Check List No-11
7Undertaking for payment of Cost of CA Check List-12
8Undertaking for payment of NPV & Additional NPV CL-13 & 13(A)
9Item/component wise breakup of the Forest Land
10Length and Width of Scheme Passing through proposed forest and Non Forest land
11Joint Inspection Report
12Undertakings
13Certificate of Non availability of Non Forest Land
14Distance Certificate from Eco Sensitive Zone
15Layout Plan of the Proposed Site
16Administrative Financial Approval of the Project