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/PB/Pipeline/146466/2021   (ii). Name of Project for which Forest Land is required : Laying of Drinking water pipeline to various villages in Distt. Patiala   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 0.456 HA of Forest Land {(0.2250 Ha. at Narwana Branch Canal RD 78 – 81 RHS WTP Site Pabra), (0.0945 HA at Bahadurghar to Ghanaur Road from Shekhu pura to Siyalu RHS, Mandauli Cluster), (0.1365 HA at Banur Canal RD Nanhera to Bhuri Majra (RHS)} for the laying of drinking water Pipe line   (iv). State : Punjab   (v). Category of the Proposal : Pipeline   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 38403.55   (viii). Area of forest land proposed for diversion(in ha.): 0.456   (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 : WATER SUPPLY & SANITATION DIV. RAJPURA   (ii). Address1 : Water Supply & Sanitation Division. Rajpura Distt Patiala   (iii). Address2 : NIL   (iv). State : Punjab   (v). District : Patiala   (vi). Pin : 140401   (vii). Landmark : NIL   (viii). Email address : pbwssdrajpura@gmail.com   (ix). Landline Telephone No. : 842-7754491   (x). Fax No. : 842-   (xi). Mobile No. : 8427754491   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Ramanpreet   (ii). Middle Name: NIL   (iii). Last Name: Singh   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Ramanpreet Singh, Executive Engineer, Water Supply and Sanitation Division, Rajpura, Distt. Patiala   (vii). Address 2: NIL   (viii). State: Punjab   (ix). District: Patiala   (x). Tehsil: Rajpura   (xi). Pin: 140401   (xii). Landmark: NIL   (xiii). Email Address: pbwssdrajpura@gmail.com   (xiv). Landline Telephone No.: 842-7754491   (xv). Fax No.: NIL   (xvi). Mobile No.: 8427754491   (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.Patiala0.4560
Total0.4560
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Patiala0.4560
Total0.4560
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Various Villages0.4560
Total 0.456 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Narwana Branch Canal RD 78 – 81 RHS WTP Site Pabra0.2250
2Bahadurghar to Ghanaur Road from Shekhu pura to Si0.09450
3Banur Canal RD Nanhera to Bhuri Majra RHS0.13650
Total 0.456 0
C. Maps of forest land proposed to be diverted
Division 1. : Patiala
  (i). Area of forest land proposed to be diverted(in ha.) : 0.456   (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).
1.0.456    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): 150   (iii). Temporary Employment(Number of person-days): 150
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
1Authority Letter
2Annexure A
3Application
4Affadavit
5Approved lay out plans
6Certificate
7Detail Note of the Project
8Detail of Non Forest Land
9Form A
10GEO REFERENCE Map
11Justification
12Minimum Use of Forest Land
13PWD NOC in English
14PWD NOC in Punjabi
15NOC from Drainage Department in English
16NOC from Drainage Department in Punjabi
17Project Approval
18Undertaking for FCA 1980
19Undertaking for FRA 2006
20Undertaking for Payment of Additional Compensatory Afforestation
21Undertaking for Payment of Additional Net Present Value
22Undertaking for Payment of Compensatory Afforestation
23Undertaking for Payment of Cost of Trees
24Undertaking for Payment of Net Present Value
25Undertaking for Payment of Penal Compensatory Afforestation
26Undertaking for Payment of Penal Net Present Value
27Undertaking for the Project is Govt