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/Others/14616/2015   (ii). Name of Project for which Forest Land is required : Mussoorie Sewerage Scheme Under U.I.D.S.S.M.T. in Manor house and Shishu Niketan Pvt. Notified Forest Estate, Mussoorie.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Mussooorie is a famous tourist place and to keep it neat and clean efforts are being don by various Dept. Under UIDSSMT Programme of Govt. of India Uttarakhand Payjal Nigam, Mussoorie has been allotted to construct a sewerage line from Makinan pump house to ITBP campus.   (iv). State : Uttarakhand   (v). Category of the Proposal : Others   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 6173   (viii). Area of forest land proposed for diversion(in ha.): 0.1186   (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): 30
A-2. Details of User Agency
  (i). Name : UTTARAKHAND PAYJAL SANSADHAN VIKAS AVAM NIRMAN NIGAM   (ii). Address1 : 11-Mohini Road, Dehradun   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Dehradun   (vi). Pin : 248001   (vii). Landmark : NIL   (viii). Email address : eecdujnmussoorie@gmail.com   (ix). Landline Telephone No. : 135-2733132   (x). Fax No. : 135-2733132   (xi). Mobile No. : 7830500497   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State PSU
A-3. Details of Person Making Application
  (i). First Name: Pratap   (ii). Middle Name: Singh   (iii). Last Name: Negi   (iv). Gender: Male   (v). Designation: A.A.E.   (vi). Address 1: 33-Jakhan, Rajpur Road, Dehradun.   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Dehradun   (x). Tehsil: Dehradun   (xi). Pin: 248001   (xii). Landmark: NIL   (xiii). Email Address: panwar.santosh6@gmail.com   (xiv). Landline Telephone No.: 135-2736032   (xv). Fax No.: NIL   (xvi). Mobile No.: 9927171375   (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.Mussoorie0.11860
Total0.11860
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Dehradun0.11860
Total0.11860
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Shergadi Zone0.11860
Total 0.1186 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Sewer line0.11860
Total 0.1186 0
C. Maps of forest land proposed to be diverted
Division 1. : Mussoorie
  (i). Area of forest land proposed to be diverted(in ha.) : 0.1186   (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).
1.0.1186    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): 2   (iii). Temporary Employment(Number of person-days): 450
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?: 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
1Objection removal letter
2NPV Amount.
3Part 1 user agency
4Part II Forest depart.
5Geo-referance map
6FRA
7aurthority letter
8Noc of Fortune Resort Grace and ITBP Mussoorie
9Topo Map
10Farm A Part-1
11objection removal letter.
12lease period
13Fact sheet
14Prativedan
15Estimate of Plantation
16Objection removal letter
17Administrative and financial sanction
18Geologist certificate
19Complying geologist task force recommendation.pdf
20Environmental clearance cer
21Alternative cer
22Lay out plan
23Length width of project
24Bearing the cost of NPV
25LPG kerosine certi
26Muck dumping cer
27No animal will be effected cer
28NOC of aam sabha
29Num of villages will be benifited
30Rate of forest land cer
31RCC demarkation certi
32Standard condition cer
33Task force certificate
34Blank spaces plantation cert
35Undertaking of bearing the cost of effected trees
36Undertaking reg cost of CA
37Regarding acknowledgement slip which is uploaded Sec-L additional information S.No-33
38Original hard copies of the proposals already have been sent to the forest nodal office Dehradun vide letter no 1426/van bhoomi/37 dated 17-10-2016 and 1523/van bhoomi/43 dated 09-11-2016 and also sent to forest division office Mussoorie, original copies of digital maps attached along with submitted proposals.
39Receipt of original copies from nodal office Dehradun
40Objection removal letter.
41Certificate of distance from national park/wild life centenary.
42Objection removal letter
43Acknowledgement Slip has been uploaded
44Objection removal letter and receiving of the proposal.
45Joint Inspection Report
46Land schedule
47Bar Chart
48National Park and wild life century certificate
49Environmental Certificate
50Objection Removal sheet
51Sthal Visistha
52Wrok has not been started
53Objection removal letter
54No alternate suitable non forest land is avilable
55No historical place will be affected
56No tree will be affected certificate