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/23336/2016   (ii). Name of Project for which Forest Land is required : Construction of Pothing Toli Motor Road (Length 7.00km)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of Pothing Toli Motor Road (Length 7.00km) Starting from Km 02 of Pothing Baghat minder Motor Road. Connecting Villages of Pothing, Chorkharak & Sumati Teshsil-Kapkot, District-Bageshwar   (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) : 322   (viii). Area of forest land proposed for diversion(in ha.): 4.287   (ix). Non-forest land required for this project(in ha.): 0.612   (x). Total period for which the forest land is proposed to be diverted(in years): 100
A-2. Details of User Agency
  (i). Name : PWDKAPKOT   (ii). Address1 : C.D.P.W.D.KAPKOTE   (iii). Address2 : BAGESHWAR   (iv). State : Uttarakhand   (v). District : Bageshwar   (vi). Pin : 263642   (vii). Landmark : Kapkot   (viii). Email address : cdpwdkapkot@gmail.com   (ix). Landline Telephone No. : 5963-253385   (x). Fax No. : 5963-253385   (xi). Mobile No. : 9639377012   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Sanjay Kumar Pandey   (ii). Middle Name: Kumar   (iii). Last Name: Pandey   (iv). Gender: Male   (v). Designation: E.E.   (vi). Address 1: C.D.P.W.D.KAPKOTE   (vii). Address 2: BAGESHWAR   (viii). State: Uttarakhand   (ix). District: Bageshwar   (x). Tehsil: Kapkot   (xi). Pin: 263642   (xii). Landmark: kapkot   (xiii). Email Address: cdpwdkapkot@gmail.com   (xiv). Landline Telephone No.: 5963-253385   (xv). Fax No.: 05963253385   (xvi). Mobile No.: 9719471059   (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.Bageshwar4.2870.612
Total4.2870.612
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bageshwar4.2870.612
Total4.2870.612
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Pothing2.150.21
2Toli2.1370.402
Total 4.287 0.612
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road4.2870
2Nap Land(Muck Dispogal)00.612
Total 4.287 0.612
C. Maps of forest land proposed to be diverted
Division 1. : Bageshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 4.287   (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).
1.4.287    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): 18000
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. : Bageshwar
  (a). Village: Shumgar   (b). Area(in ha.): 8.574   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 1   (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
1Eds Dated 26-03-2018
2A short narrative and importance of the project
3Administrative and Financial sanction
4Preliminary Joint Inspection report
5Comperative chart showing statement of both alignment or alternate
6Certificate from the DM that no alternative suitable non-forest
7Land schedule
8Category wise RFcivil soyam Van panchayat and private nap land
9Bar Chart
10Compensatory afforestation scheme in Civil and Soyam land 10 Year
11Certificate reg. suitability of indentified land for Comensatory
12Undertaking by the User Agency to bear the cost of compensatory
13Road side/gap filling plantation estimate
14Undertaking by the User Agency to bear the cost of Road side
15Details of the trees with their scientific name in RF, Civil Soyam
16II Aligement Tree
17If felling of trees is not involved certificate by DFO in this regard
18Certificate of felling minimum trees during the project work
19Muck disposal scheme
20Whether project area is a part of National Park or sanctuary and airal
21No voilation has taken place, FC Act. 1980 reg.
22NOC from local Gram Sabhas
23Certificate- work has not been started reg
24Geologist Report
25Task Force report
26Manak Shartain
27Certificate by user agency for complying the condition imposed in geologist report ask Forcex recommendation in hill areas
28No historical monumental or relegeous place will be effected
29Undertaking regarding no animal will be effected adversely by the
30receiving copy Nodal
31EDS 10-07-2018
32DFO PART-II
33CF PART-III
34NODAL-IV
35hard copy reciving letter
36STATE -V
37View Form A Part II
38Eds Dated 01-01-2020
39Undertaking to provide alternative fuelwood, kerosene or LPG to
40Undertaking of payment of NPV if Honble Supreem Court increses
41NPV CALCULAT
42Eds Dated 13-08-2019(toli)
43NPV calculation certificate
44Eds Dated 16-01-2019