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/KA/Others/28747/2017   (ii). Name of Project for which Forest Land is required : For laying of Zip Line with walking path and construction of Base Structure in Chamundibetta RF, Mysore Division & District in favour of the Deputy Director, Department of Tourism, Mysore.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 0.222 ha. forest land in Sy.No. 3 of Chamundibetta Village & Sy.No.28 of Lalitadripura Village, Chamundi Betta RF, Mysore Range, Mysore Division & District and 0.0146 ha. of non-forest land in Sy.No.166 of Lalithadripura village for laying Zipline with walking and Base Structure   (iv). State : Karnataka   (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) : 9500000   (viii). Area of forest land proposed for diversion(in ha.): 0.2219   (ix). Non-forest land required for this project(in ha.): 0.0146   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : TOURISM DEPARTMENT MYSORE   (ii). Address1 : OFFICE OF DEPUTY DIRECTOR, TOURISM DEPARTMENT, MYSORE DIVISION, # 2, HOTEL MAYURA HOYSALA, JLB ROAD, MYSORE, MYSORE DISTRICT.   (iii). Address2 : NIL   (iv). State : Karnataka   (v). District : Mysore   (vi). Pin : 570005   (vii). Landmark : JLB ROAD, NEAR RAILWAY STATION   (viii). Email address : mysoreadventuretourism@gmail.com   (ix). Landline Telephone No. : 821-244096   (x). Fax No. : 821-0   (xi). Mobile No. : 9611921927   (xii). Website (if any) : Nil   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Janardhana   (ii). Middle Name: HP   (iii). Last Name: Janardhana   (iv). Gender: Male   (v). Designation: DeputyDirector   (vi). Address 1: Janardhana H.P, Deputy Director, Department of Tourism, No.2, Hotel Mayura Hoysala Complex, JLB Road, Mysore, Mysore District-570005   (vii). Address 2: NIL   (viii). State: Karnataka   (ix). District: Mysore   (x). Tehsil: Mysore   (xi). Pin: 570005   (xii). Landmark: JLB ROAD   (xiii). Email Address: mysoreadventuretourism@gmail.com   (xiv). Landline Telephone No.: 821-244096   (xv). Fax No.: 00   (xvi). Mobile No.: 9611921927   (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.Mysore0.22190.0146
Total0.22190.0146
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Mysore0.22190.0146
Total0.22190.0146
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Sy.No.3 of Chamundibetta Village0.01930
2Sy.No.28 of Lalithadripura Village0.20250
3Sy.No.166 of Lalithadripura Village00.0146
Total 0.2218 0.0146
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Zip line with walking path (1 to 3A)0.01330
2Base Structure – A0.0060
3Zip Line (A to D)0.16250
4Base Structure (B-C-D)0.0090
5Walking track (D to 4)0.03110
6Zip Line (P1 to P2)00.0146
Total 0.2219 0.0146
C. Maps of forest land proposed to be diverted
Division 1. : Mysore
  (i). Area of forest land proposed to be diverted(in ha.) : 0.2219   (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.
1.0.2219    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 ?: No
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
1Essential details sought by Nodal Officer on 28-08-2017. The same is enclosed
2Authorization Letter
3Clubbed Map (2 Village Map + 1 Forest Block Map)
4Component Wise Breakup details
5Geo Referenced Map
6Google Map
7Justification Letter
8Toposheet Map
9Undertaking for payment of NPV & CA
10Village Map-1
11Map-2
12Map-3
13As per HANDBOOK OF Forest (Conservation) Act, 1980, No compensatory Afforestation shall be insisted upon in respect of Proposals involving diversion of forest land upto one hectare.