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/UK/HYD/17611/2016   (ii). Name of Project for which Forest Land is required : KHUTANI SMALL HYDRO ELECTRIC PROJECT (21 MW)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : IMPLEMENTATION OF KHUTANI SMALL HYDRO ELECTRIC PROJECT (21 MW). CONSTRUCTION OF DIVERSION WEIR, INTAKE, DESILTING CHAMBER, WATER CONDUCTING SYSTEM(TUNNEL), SURGE SHAFT, PENSTOCK, POWER HOUSE, TAIL POOL, TAIL RACE CHANNEL, SWITCH YARD, COLONY & PROJECT ROAD ETC.   (iv). State : Uttarakhand   (v). Category of the Proposal : Hydel   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 210.47   (viii). Area of forest land proposed for diversion(in ha.): 3.52   (ix). Non-forest land required for this project(in ha.): 8.85   (x). Total period for which the forest land is proposed to be diverted(in years): 40
A-2. Details of User Agency
  (i). Name : KHUTANI POWER COMPANY PVT LTD   (ii). Address1 : PLOT NO-49, 4TH FLOOR, SECTOR-44, GURGAON, HARYANA   (iii). Address2 : NIL   (iv). State : Haryana   (v). District : Gurgaon   (vi). Pin : 122002   (vii). Landmark : NEAR EPFO OFFICE   (viii). Email address : info@khutanipower.com   (ix). Landline Telephone No. : 124-2645000   (x). Fax No. : 124-2645120   (xi). Mobile No. : 9971994103   (xii). Website (if any) : www.khutanipower.com   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: RAJAPPAN K PILLAI   (ii). Middle Name: KRISHNA   (iii). Last Name: PILLAI   (iv). Gender: Male   (v). Designation: GENERAL MANAGER (PROJECTS)   (vi). Address 1: KHUTANI POWER CO.Pvt.lTD., GANAI(Tehsil), BANKOT (PO), PITHORAGARH (Dt.), UTTARAKHAND-262532   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Pithoragarh   (x). Tehsil: Gangolihat   (xi). Pin: 262532   (xii). Landmark: Sateshwar Temple Batgeri Village   (xiii). Email Address: info@khutanipower.com   (xiv). Landline Telephone No.: 124-2645000   (xv). Fax No.: 01242645120   (xvi). Mobile No.: 7055217051   (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.Pithoragarh3.188.85
2.Bageshwar0.340
Total3.528.85
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Pithoragarh3.188.85
1.Bageshwar0.340
Total3.528.85
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1BATGARI/NAGHAR1.241.54
2SIRSOLI0.72.82
3DUNAI0.410.61
4BHANMATI0.833.88
5KATHANI0.340
Total 3.52 8.85
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1DIVERSION WEIR & INTAKE0.4120.413
2FEEDER CHANNEL0.080
3DESILTING CHAMBER & TUNNEL PORTAL0.160
4WATER CONDUCTING SYSTEM (TUNNEL)0.8251.375
5ADIT-II PORTAL0.0690
6ADIT-I0.0620
7ADIT-II0.0420
8SURGE SHAFT0.040
9PENSTOCK0.110.04
10POWER HOUSE & TAIL POOL0.030.22
11TAIL RACE CHANNEL0.150
12SWITCH YARD00.06
13COLONY & STORE00.3
14PROJECT APPROACH ROAD1.480.52
15MUCK DUMPING AREA-I00.907
16MUCK DUMPING AREA-II02.045
17MUCK DUMPING AREA-III02.97
18ADIT-I PORTAL0.060
Total 3.52 8.85
C. Maps of forest land proposed to be diverted
Division 1. : Bageshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 0.34   (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.
1.0.34    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. : Pithoragarh
  (i). Area of forest land proposed to be diverted(in ha.) : 3.18   (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.
1.3.18    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 ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 0   (iii). Temporary Employment(Number of person-days): 219000
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. : Pithoragarh
  (a). Village: Bhanmati   (b). Area(in ha.): 7.04   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 971   (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:
M. Hydel/Irrigation/Multipurpose Project
  (i). Installed power generation capacity of the Project(in MW): 21   (ii). Total command area of the Project(in ha.): 3.52   (a). Copy of the approval of competent authority to the Catchment Area Treatment Plan (CAT Plan):   (b). Copy of the approved CAT plan:
Additional information Details
Documents
S.No Documents
Remarks
1MUCK DISPOSAL PLAN
2UNDERTAKING ABOUT TRANSMISSION LINE
3TECHNO ECONOMIC CLEARANCE CERTIFICATE (TEC)
4DETAILS OF TRANSMISSION LINE
5Brief Synopsis of the Project
6FACT SHEET
7PRATIVEDAN
8IMPLEMENTATION AGREEMENT
9FORM 1 & 2
10APPROVAL OF DPR
11SITE INSPECTION REPORT
12MINIMUM FOREST LAND USE AND NO ALTERNATE LAND AVAILABLE
13LAND SCHEDULE 01
14LAND SCHEDULE 02
15LAND SCHEDULE 03
16LAND SCHEDULE 04
17LAND SCHEDULE 05
18LAND SCHEDULE 06
19CERTIFICATE OF LENGTH & WIDTH
20BAR CHART
21CERTIFICATE OF NO WORK START
22CERTIFICATE OF AFFECTED TREES DETAILS
23CERTIFICATE OF AFFECTED TREES COST
24CERTIFICATE OF AFFECTED TREES SUMMERY
25CERTIFICATE OF TREES PHYSICAL QUANTITY
26CERTIFICATE OF EFFECTED TREES BY DFO
27CERTIFICATE OF MINIMUM TREE CUTTING
28CERTIFICATE OF NO NATIONAL PARK & WILD LIFE WITH AIR DISTANCE
29NOCs FROM GRAM PRADHANS
30LAND DETAIL OF PROJECT
31PROJECT LAYOUT PLAN DRAWING
32GEOLOGICAL SURVEY OF INDIA REPORT
33GEOLOGIST REPORT OF CONSULTANT
34TASK FORCE CERTIFICATE & UNDERTAKING
35Undertaking for no harm to wild life
36Undertaking for availability of Kerosine and cooking gas
37LIST OF VILLAGERS BENIFITED
38CERTIFICATE OF LEASE RENT
39COMPENSATORY AFFORESTATION PLAN
40COMPENSATORY AFFORESTATION LAND SUITABILITY CERTIFICATE
41TREE PLANTATION ON VACANT AREA
42NPV COST
43NPV UNDERTAKING
44CERTIFICATE OF LEASE PERIOD
45RCC PILLAR COST
46ACCEPTANCE OF FOREST ACT
47UNDERTAKING OF ENVIRONMENTAL CLEARANCE