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/ROAD/153630/2022   (ii). Name of Project for which Forest Land is required : Development of 6 Lane Access Controlled Greenfield Highway of Shamli - Ambala Sec. from Km Ch. 0+000 to Km Ch. 120+970 (Total length: 120.970 km) in the States of Uttar Pradesh, Haryana & Punjab under Bharatmala Pariyojana Phase II (Lot- 9/Package-l).   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The Proposed highway passes through the four districts of Haryana i.e Karnal, YamunaNagar, Kurukshetra & Ambala. At some locations (crossings point of roads/railway line/canal/drain/river bund etc.), the proposed project falls in in notified protected forest areas declared for management purposes.   (iv). State : Haryana   (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) : 160847   (viii). Area of forest land proposed for diversion(in ha.): 3.7381   (ix). Non-forest land required for this project(in ha.): 354.4619   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : NHAI PIU I AMBALA HARYANA   (ii). Address1 : 17 L model Town Ambala City   (iii). Address2 : NIL   (iv). State : Haryana   (v). District : Ambala   (vi). Pin : 134003   (vii). Landmark : NIL   (viii). Email address : piu1amb@gmail.com   (ix). Landline Telephone No. : 171-2521361   (x). Fax No. : 171-   (xi). Mobile No. : 9416976349   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: Veerendera   (ii). Middle Name: NIL   (iii). Last Name: Singh   (iv). Gender: Male   (v). Designation: General Manager Technical   (vi). Address 1: # 16, Prem Nagar, Ambala City   (vii). Address 2: NIL   (viii). State: Haryana   (ix). District: Ambala   (x). Tehsil: NIL   (xi). Pin: 134003   (xii). Landmark: NIL   (xiii). Email Address: piu1amb@gmail.com   (xiv). Landline Telephone No.: 171-2521361   (xv). Fax No.: NIL   (xvi). Mobile No.: 9599678828   (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
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
1InprincipleFP/PB/ROAD/120862/20219-PBC328/2022-CHA11.48611.48620 May 2022
Total 11.486 11.486
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.Karnal0.47739.663
2.Yamuna Nagar1.022299.5978
3.Kurukshetra0.02919.331
4.Ambala2.2099195.8701
Total3.7381354.4619
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Karnal0.47739.663
1.Yamunanagar1.022299.5978
3.Kurukshetra0.02919.331
4.Ambala2.2099195.8701
Total3.7381354.4619
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Hansoo Majra0.08111.169
2Khokhani0.17512.075
3Kalri Jagir0.2218.738
4Potli0.1658.6085
5Radaur0.44484.232
6Bubka0.1420.94
7Dholra0.247220.94
8Khurdban0.02527.899
9Gajlana0.02915.111
10Alawalpur0.02213.307
11Manju Majra0.01913.31
12Sajjan Majri0.2598.897
13Ghelri0.1246.7461
14Harda0.0969.5011
15Bhita1.064925.766
16Falel Majra0.0573.81
17Mithapur0.2520.5903
18Talheri Rangran0.07815.388
19Adhoya Hindawan0.23811.3811
Total 3.7381 218.4091
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road Construction3.7381354.4619
Total 3.7381 354.4619
C. Maps of forest land proposed to be diverted
Division 1. : Karnal
  (i). Area of forest land proposed to be diverted(in ha.) : 0.477   (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).
1.0.477    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:
Division 2. : Kurukshetra
  (i). Area of forest land proposed to be diverted(in ha.) : 0.029   (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).
1.0.029    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:
Division 3. : Yamuna Nagar
  (i). Area of forest land proposed to be diverted(in ha.) : 1.0222   (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).
1.1.022    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:
Division 4. : Ambala
  (i). Area of forest land proposed to be diverted(in ha.) : 2.2099   (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).
1.2.2099    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): 250   (iii). Temporary Employment(Number of person-days): 2500
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.: 10/33/2021-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? : 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
1Area Calculation
2Undertaking Compensatory Afforestation
3Undertaking FRA
4Undertaking of Minimum Use of Forest
5Undertaking of No Other Feasible
6Undertaking of No Construction Activity
7Undertaking of No Muck
8Undertaking of No Wildlife
9Undertaking of NPV
10Project Description
11Justification of Project
12Area calculation sheet showing dimension wise proposed forest area calculation .
13Approved LAC for Project Sanction
14Undertaking for NOC from respective Departments
15Layout Plan
16Revised Area Calculation for YamunaNagar
17Revised Layout Plan for YamunaNagar
18Compliance for DFO Yamuna Nagar against letter No.2138
19Revised Undertakings for YamunaNagar