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/TG/ROAD/40170/2019   (ii). Name of Project for which Forest Land is required : Road Network in Backward areas of Charla Mandal of Bhadradri Kothagudem District - 31.084 Ha   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 31.084 Ha of forest land in Bhadrachalam Division for Road Network in Backward areas connecting Battaigudem, Rallapuram, Tippapuram, Uyyalamadugu , Bathinapally of Charla Mandal of Bhadradri Kothagudem District in favour of R&B Department   (iv). State : Telangana   (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) : 2569.9   (viii). Area of forest land proposed for diversion(in ha.): 31.084   (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): NIL
A-2. Details of User Agency
  (i). Name : ROADS AND BUILDINGS DEPARTMENT   (ii). Address1 : Executive Engineer,Roads and Buildings, Kothagudem   (iii). Address2 : NIL   (iv). State : Telangana   (v). District : Khammam   (vi). Pin : 507101   (vii). Landmark : NIL   (viii). Email address : eekothagudem@yahoo.com   (ix). Landline Telephone No. : 8744-242779   (x). Fax No. : 8744-   (xi). Mobile No. : 9440818086   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Rajeshwar Reddy   (ii). Middle Name: NIL   (iii). Last Name: G   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Roads & Buildings, Kothagudem   (vii). Address 2: NIL   (viii). State: Telangana   (ix). District: Khammam   (x). Tehsil: Kothagudem   (xi). Pin: 507101   (xii). Landmark: NIL   (xiii). Email Address: eekothagudem@yahoo.com   (xiv). Landline Telephone No.: 8744-242779   (xv). Fax No.: NIL   (xvi). Mobile No.: 9440818086   (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.Bhadrachalam31.0840
Total31.0840
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bhadradri Kothagudem31.0840
Total31.0840
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Rallapuram, Battaigudem, Uyyalamadugu, Tippapuram,31.0840
Total 31.084 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road31.0840
Total 31.084 0
C. Maps of forest land proposed to be diverted
Division 1. : Bhadrachalam
  (i). Area of forest land proposed to be diverted(in ha.) : 31.084   (ii). Nature of the Project: Linear   (b). No. of Segments : Two
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).
1.15.626    View File
2.15.458    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: No   (a). Reason for not providing such map: There is no other 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): 1000
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?: Yes   (a). Copy of Cost-Benefit analysis:
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? : Yes
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: Three
District 1. : Bhadradri Kothagudem
  (a). Village: Thirumalakunta Village   (b). Area(in ha.): 18.5352   (c). Copy of KML file of the patch:     View File   (d). Khasra details: Sy.no. 153/1, Thirumalakunta village, Aswaraopet Mandal   (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:
District 2. : Bhadradri Kothagudem
  (a). Village: Asupaka   (b). Area(in ha.): 3.5521   (c). Copy of KML file of the patch:     View File   (d). Khasra details: Sy.No.227, Asupaka Village. Aswaraopet Mandal   (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:
District 3. : Bhadradri Kothagudem
  (a). Village: Jaganathapuram Village   (b). Area(in ha.): 12.3166   (c). Copy of KML file of the patch:     View File   (d). Khasra details: Sy.No.626/1, Jaganathapuram Village, Mulkalapally mandal   (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
1Form-A
2Undertakings
3Lat Long of diversion