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/ROAD/21204/2016   (ii). Name of Project for which Forest Land is required : construction of Gairsain (Aagarchatti) to Syuni Malli Motor Road under PMGSY.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The road is for providing connectivity to the village Syuni malli situated in block Gairsain of district Chamoli. The Population being served with the road is 425 numbers. Total length of the road is 6.00 km.   (iv). State : Uttarakhand   (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) : 480   (viii). Area of forest land proposed for diversion(in ha.): 4.37   (ix). Non-forest land required for this project(in ha.): 0.28   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : RES PMGSY KARANPERAYAG   (ii). Address1 : Karanprayag   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Chamoli   (vi). Pin : 246444   (vii). Landmark : NIL   (viii). Email address : eepmgsykaranprayag1@rediffmail.com   (ix). Landline Telephone No. : 1363-244843   (x). Fax No. : 1363-0   (xi). Mobile No. : 9412056922   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: sachin   (ii). Middle Name: NIL   (iii). Last Name: kumar   (iv). Gender: Male   (v). Designation: Assistant Engineer   (vi). Address 1: Karanprayag   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Chamoli   (x). Tehsil: Karnaprayag   (xi). Pin: 246444   (xii). Landmark: NIL   (xiii). Email Address: eepmgsykaranprayag1@rediffmail.com   (xiv). Landline Telephone No.: 1363-244843   (xv). Fax No.: NIL   (xvi). Mobile No.: 7895282436   (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.Kedarnath Wild Life Division,Gopeshwar4.370.28
Total4.370.28
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Chamoli4.370.28
Total4.370.28
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Syuni Malli4.370.28
Total 4.37 0.28
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road3.920.28
2Muck disposal (km-1)0.140
3Muck disposal (km-2 and km-3)0.099960
4Muck disposal (km-4)0.090
5Muck disposal (km-5)0.120
Total 4.36996 0.28
C. Maps of forest land proposed to be diverted
Division 1. : Kedarnath Wild Life Division,Gopeshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 4.37   (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).
1.4.37    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): 15340
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. : Chamoli
  (a). Village: Jasyara kandara   (b). Area(in ha.): 8.74   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 4139,4104,1053   (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
1private land ownersheep proof
2comparison between identified alignment for the road.
3Combined Inspection report
4certificate for utility value
5Certificate for no alternative suitable non-forest land for the project and that demand is barest to the minimum
6compensatory Afforestation scheme
7Bar chart of land schedule and land schedule
8Certificate regarding suitability identified land of compensatory Afforestation by DFO
9certificate for bearing the cost CA
10Certificate for minimum falling of trees of the road
11Certificate for bearing the cost of road side plantation
12Estimate for road side plantation
13Details of trees falling in the proposed alignment of the road
14Details of Baanjh trees
15cover page of the proposal
16Cost of the forest land
17NPV calculation Certificate as per Honable Supereme Court/MoEF orders and Understanding of payment of NPV,if Honable Supreme Court increases the rates of NPV
18Benefited Village(s)/Families/Population Certificate Court/MoEF orders and Understanding of payment of NPV,if Honable Supreme Court increases the rates of NPV
19Undertaking regarding no animal will be affected adversely by the project and to provide alternative fuel wood .kerosene or LPG to labourers involved in the projec
20Certificate that no historical/monumental or religious place will be affected . report,standard conditions and certificate to follow the conditions imposed by task force /geologis
21standard conditions and certificate to follow the conditions imposed by task force /geologis or religious place will be affected . report,standard conditions and certificate to follow the conditions imposed by task force /geologis
22Task force certificate
23Geologist Report
24Certificate for Not staring the work
25Certificate that no violation of the FA 1980 has taken place.
26Cost of the Demarcation of land to be diverted and Understanding of user agency to bear the cost for Demarcation work
27Copy of Land identification Map
28Brief description of the road
29Muck Disposal plan
30Justification of the Project
31EDS reply by User Agency on dated 18.08.18
32EDS reply by User Agency on dated 27.02.18
33Regarding technical and financial sanction
34comparison between identified alignment for the road
35certificate for bearing the cost of NPV
36NOC of the Gram sabha
37Part-1
38Certificate that the project is not a part of National park or Sanctuary and the aerial distance.