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/WATER/18810/2016   (ii). Name of Project for which Forest Land is required : BORABAS MANDANA WATER SUPPLY PROJECT KOTA (RAJASTHAN)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Borabas Mandana Water Supply Project was framed to cater drinking water demand of 60 villages & 21 OH of district Kota,approximate 361 KM pipeline is laying in these villages for water supply.   (iv). State : Rajasthan   (v). Category of the Proposal : Drinking Water   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 9047.48   (viii). Area of forest land proposed for diversion(in ha.): 4   (ix). Non-forest land required for this project(in ha.): 19.14   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : EXECUTIVE ENGINEER PHED PROJECT DIVISION I KOTA   (ii). Address1 : PHED PROJECT DIVISION-I, DADABARI KOTA   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Kota   (vi). Pin : 324009   (vii). Landmark : NEAR CHAMBAL GARDEN   (viii). Email address : rj.eepd1kota@gmail.com   (ix). Landline Telephone No. : 744-2501961   (x). Fax No. : 744-2501961   (xi). Mobile No. : 8387891666   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: PRAKASH   (ii). Middle Name: CHAND   (iii). Last Name: JAIN   (iv). Gender: Male   (v). Designation: EXECUTIVE ENGINEER   (vi). Address 1: PHED PROJECT DIVISION-I,DADABARI KOTA   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Kota   (x). Tehsil: Ladpura   (xi). Pin: 324009   (xii). Landmark: NEAR CHAMBAL GARDEN   (xiii). Email Address: hemant_phed@rediffmail.com   (xiv). Landline Telephone No.: 744-2501961   (xv). Fax No.: 07442501961   (xvi). Mobile No.: 8387891666   (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.Mukundra NP0.860.76
2.Kota Territorial3.1418.38
Total419.14
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Kota419.14
Total419.14
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Borabas0.124540.3309
2Prathvipura0.04550.09048
3Keshopura0.10450.07774
4jaspura0.19240
5Rojhala0.12370
6Mandirgarh0.039780.0429
7Rathkankara0.104260.1422
8Kishanpura0.130520.08086
9Lakshmipura@kolana0.39970
10Khanpuriya0.10450
11Ranpur0.0480.38
12Daulatganj0.18190.32
13Rojhari0.18170.16
14Vijaypura0.1680
15Jagpura0.33990.54
16Pachankui0.25580
17Bandha0.05660.34
18Kishor sagar0.00720
19Anandpura@Foot Talav0.07880.24
20Anandpura0.14960.36
21Lakhawa0.26010.42
22Kable Nagar0.12750.16
23Sohanpura00.7
24Gopalpura00.96
25Kaliyakheri00.54
26Ummedpura00.41
27Daulatpura00.23
28Anwali00.12
29Aalniya0.0120.28
30Mandliya00.4
31Dobra0.03380.57
32Jodhpura00.3
33Sarangpur0.08040.2
34Tholpura00.45
35Kasar0.08070.47
36Bakshpura00.45
37Shayampura0.1110.38
38Baudikhera00.24
39Rankayakheri0.1530.49
40Heerapura00.39
41Pachpahar0.07580.26
42Nayagaon (Dobra)00.52
43Doliya0.22740.31
44Kanwarpura00.23
45Mandana01.23
46Bhilod00.29
47Bhilkheri00.36
48Phatakhera00.42
49Bhanwariya00.46
50Kothala00.26
51Dharampura00.41
52Mukundpura00.46
53Mohanpura00.37
54Chandbaori00.26
55Ranwtha00.52
56Singhpura00.25
57Hanotiya00.48
58Morukalan00.2
59Haripura00.26
60Morukhurad00.29
Total 3.9986 19.10508
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying of Pipeline@350 mm0.713830.47617
2Laying of Pipeline@2500.59281.031025
3Laying of Pipeline@200 mm0.32131.8522
4Laying of Pipeline@150 mm0.854753.540615
5Construction of ESR02.76
6Laying of Pipeline@100 mm1.4584789.41946
Total 3.941158 19.07947
C. Maps of forest land proposed to be diverted
Division 1. : Mukundra NP
  (i). Area of forest land proposed to be diverted(in ha.) : 0.86   (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).
1.0.86    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. : Kota Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 3.14   (ii). Nature of the Project: Linear   (b). No. of Segments : Six
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).
1.0.713    View File
2.0.592    View File
3.0.321    View File
4.0.854    View File
5.0.659    View File
6.1E-10    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): 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? : Yes   (a). Whether Project or a part thereof is located within a Protected Area ? : Yes   (b). Status of approval of the Supreme Court : Approval obtained   (c). Date of Approval : NIL   (d).Copy of the approval of the Supreme Court:   (ii). Status of approval of the Standing Committee of National Board for the Wildlife(NBWL) to the Project : Approval obtained   (a). MoEF File No : F.No.6-48/2015 WL (34th Meeting)   (b). Copy of approval of Standing of the NBWL:   (c). Date of Approval : 24 Jun 2015
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. : Kota
  (a). Village: Jodhpura   (b). Area(in ha.): 4   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 407   (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
1CA Land Documents.
2Railway NOC.
3Khasra Map.
4Augmentation Plan.
5Forest Land Village List.
6Wildlife Village List.
7Bar Chart Status.
8Borabas Mandana Area Calculation Sheet.
9Work Order and Agreement Letter.
10Technical Sanction.
11Administration and Financial Sanction.
12NBWL Permission.
13Wildlife Clearance Letter.
14NHAI NOC.
15JUSTIFICATION FOR LOCATING PROJECT IN FOREST AREA.
16Undertaking for Use of Any Material From Forest Land.
17UNDERTAKING FOR CONSERVATION OF FLORA FAUNA DURING LAYING OF PIPELINE.
18UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED FOREST LAND.
19UNDERTAKING FOR NO OTHER FEASIBLE ALTERNATIVE AND DIVERSION OF MINIMUM FOREST LAND.
20UNDERTAKING FOR PAYMENT OF ANY OTHER COST AND CONDITION.
21UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION.
22UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA.
23UNDERTAKING FOR USE OF FOREST LAND.
24Undertaking for Waste Management.
25FRA Certificate Additional Details.
26GOOGLE MAP.