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/HR/Approach/42016/2019   (ii). Name of Project for which Forest Land is required : Diversion of forest land 0.006032 HAc. for the access to the proposed retail outlet of Indian Oil Corporation Ltd. along on Pinagwa to Akbarpur Road (L.H.S.) at Village-Pinagwa, Tehsil- Punhana, Distt-   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of forest land 0.006032 HAc. for the access to the proposed retail outlet of Indian Oil Corporation Ltd. along on Pinagwa to Akbarpur Road (L.H.S.) in plot with, Mustil/Killa No-131//16, Khewat No-104, at Village-Pinagwa, Tehsil- Punhana, Distt-Mewat, Haryana.   (iv). State : Haryana   (v). Category of the Proposal : Approach Access   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 40   (viii). Area of forest land proposed for diversion(in ha.): 0.00603   (ix). Non-forest land required for this project(in ha.): 0.1225   (x). Total period for which the forest land is proposed to be diverted(in years): 15
A-2. Details of User Agency
  (i). Name : M/S INDIAN OIL CORPORATION LTD.   (ii). Address1 : 83 institutional area sec-18 Guraon   (iii). Address2 : NIL   (iv). State : Haryana   (v). District : Gurgaon   (vi). Pin : 122001   (vii). Landmark : NIL   (viii). Email address : gurgaondo@gmail.com   (ix). Landline Telephone No. : 124-2340313   (x). Fax No. : 124-   (xi). Mobile No. : 9868161585   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central PSU
A-3. Details of Person Making Application
  (i). First Name: PK   (ii). Middle Name: NIL   (iii). Last Name: Jha   (iv). Gender: Male   (v). Designation: Propriter   (vi). Address 1: A-33, Rajhans Vihar, Vikash Nagar, New Delhi.   (vii). Address 2: NIL   (viii). State: Delhi   (ix). District: New Delhi   (x). Tehsil: Connaught Place   (xi). Pin: 110059   (xii). Landmark: Near H.K. Property   (xiii). Email Address: pkjha67@gmail.com   (xiv). Landline Telephone No.: 1100-25371428   (xv). Fax No.: NIL   (xvi). Mobile No.: 9868161585   (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.Mewat0.006030.1225
Total0.006030.1225
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Mewat0.006030.1225
Total0.006030.1225
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Pinagwa0.006030.1225
Total 0.00603 0.1225
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Entry0.0028750.06125
2Exit0.0028750.06125
Total 0.00575 0.1225
C. Maps of forest land proposed to be diverted
Division 1. : Mewat
  (i). Area of forest land proposed to be diverted(in ha.) : 0.00603   (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).
1.0.00603    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: Site fixed by IOCL.
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 3   (iii). Temporary Employment(Number of person-days): 3
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? : 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?: 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
1LOI
2Sizra
3Land Documents
4PWD NOC
5Covering Letter for Forest
6Covering Letter for Wild Life
7Under taking for Passage
8Undertaking for No High Tension Line
9Undertaking for No LPG godown
10Affidavit for no tree cutting
11Form A
12Detailed not e of Project
13Form A
14Check list 04
15Check list 07
16Check list 08
17Check list 10
18Check list 11
19Check list 12
20Check list 13
21Detailed Map
22DTP NOC
23Pollution NOC