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/RJ/ROAD/16024/2015   (ii). Name of Project for which Forest Land is required : Construction of BT Road From Sone Ka Gurja Road Km. 16/100 to Indora.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of BT Road From Sone Ka Gurja Road Km. 16/100 to Indora Village, Tehsil-Sirmathura, District-Dholpur (Rajasthan). under RRSMP scheme funded by the World Bank   (iv). State : Rajasthan   (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) : 179.62   (viii). Area of forest land proposed for diversion(in ha.): 4.2703   (ix). Non-forest land required for this project(in ha.): 0.5069   (x). Total period for which the forest land is proposed to be diverted(in years): 99.0
A-2. Details of User Agency
  (i). Name : PUBLIC WORKS DEPARTMENT RAJASTHAN JAIPUR   (ii). Address1 : Executive Engineer PWD Dn Bari   (iii). Address2 : Executive Engineer PWD Dn Bari   (iv). State : Rajasthan   (v). District : dholpur   (vi). Pin : 328021   (vii). Landmark : Kharoli Khasara No 1061, 1096 Biloni Khasara No.   (viii). Email address : ee_pwdbari@rediffmail.com   (ix). Landline Telephone No. : 5647-274684   (x). Fax No. : 5647-   (xi). Mobile No. : 9414219764   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Radhe Shyam   (ii). Middle Name: NIL   (iii). Last Name: Koli   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: PWD Division-Bari   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: dholpur   (x). Tehsil: Bari   (xi). Pin: 328025   (xii). Landmark: NIL   (xiii). Email Address: pwdkhidarpur@gmail.com   (xiv). Landline Telephone No.: 5647-274684   (xv). Fax No.: NIL   (xvi). Mobile No.: 9414415994   (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/RJ/ROAD/6952/2014P.1(33)Forest/20150.310.3103 Mar 2015
2InprincipleFP/RJ/ROAD/6983/2014P.1(37)Forest/20150.50.503 Mar 2015
3InprincipleFP/RJ/ROAD/6986/2014P.1(43)Forest/20150.550.5518 Mar 2015
4InprincipleFP/RJ/ROAD/6993/2014P.1(40)Forest/20150.930.9318 Mar 2015
5InprincipleFP/RJ/ROAD/7558/2014P.1(50)Forest/20150.520.5218 Mar 2015
6InprincipleFP/RJ/ROAD/7595/2014P.1(45)Forest/20150.950.9518 Mar 2015
7InprincipleFP/RJ/ROAD/7757/2014P.1(52)Forest/20150.9940.99418 Mar 2015
8InprincipleFP/RJ/ROAD/7759/2014P.1(46)Forest/20150.20.203 Mar 2015
9InprincipleFP/RJ/ROAD/7609/2014P.1(44)Forest/20150.9960.99604 Mar 2015
Total 5.95 5.95
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.Dholpur Territorial4.27030.5069
Total4.27030.5069
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.dholpur4.27030.5069
Total4.27030.5069
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Mathara2.4840
2Indora1.78630.5069
Total 4.2703 0.5069
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1construction of bt road to indora with junction4.27030.5069
Total 4.2703 0.5069
C. Maps of forest land proposed to be diverted
Division 1. : Dholpur Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 4.2703   (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).
1.4.2703    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): 0   (iii). Temporary Employment(Number of person-days): 1796
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?: Yes   (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 ?: No   (iii). No. of districts involved for raising Compensatory Afforestation: 1   (iv). No. of patches: One
District 1. : dholpur
  (a). Village: Gurhamutawali   (b). Area(in ha.): 4.2703   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 971/2   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
  (v). Scanned copy of the map of the land identified for creation of Compensatory Afforestation prepared by using GPS ot Total Station:   (vi). Copy of Survey of India Toposheet in 1:50,000 scale indicating location of the land identified for creation of Compensatory Afforestation:
Additional information Details
Documents
S.No Documents
Remarks
1Technical and Financial Sanction of Indora.
2Khasrab Map and Jamabandi of Indora.
3FRA CERTIFICATE
4INDEX MAP
5CROSS SECTION
6PROPOSED CA LAND
7bar chart
8compliance letter indora
9compliance letter
10COMPLIANCE LETTER 23.05.2019
11justification reg. project locating in Forest AREA
12UNDERTAKING OF NPV
13AREA CALCULATION SHEET
14UNDERTAKING OF CA AND PENAL CA
15FLORA AND FAUNA SAFE GUARD OF
16PROJECTING LOCATING IN FOREST AREA
17additional NPV for protection forest
18muck dumping certificae
19compliance by EEPWD BARI DATED 8.09.2020