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/39043/2019   (ii). Name of Project for which Forest Land is required : Construction of Dharmghar-Chipcheiya motor road (Length 4.00 km)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : This road starts from km 70 of Balighat Dodar Dharmaghar Kotmanya motor road. It connects revenue village of Lamgingeda and Majkera it helps to connects local village with main stream road network and help the villagers to progress by financial economic and other means of well being   (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) : 18400000   (viii). Area of forest land proposed for diversion(in ha.): 2.1   (ix). Non-forest land required for this project(in ha.): 0.7   (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.Bageshwar2.10.7
Total2.10.7
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bageshwar2.10.7
Total2.10.7
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Lamgingada(Chipcheiya)0.80.5
2Majhera1.30.2
Total 2.1 0.7
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road2.10.35
2Muck Disposal(Nap Land)00.35
Total 2.1 0.7
C. Maps of forest land proposed to be diverted
Division 1. : Bageshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 2.1   (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).
1.2.1    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): 15000
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: Dulam Civil   (b). Area(in ha.): 4.2   (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
1Authorletter
2FRA
3Note containing justification for locating the Project in forest land
4Administrative and Financial sanction
5Preliminary Joint Inspection report
6Comperative chart showing statement of both alignment or alternate
7Land schedule (for RF signed by DFO and civil soyam, Van
8Bar Chart
9Compensatory afforestation scheme in Civil and Soyam land (10 years
10Road side gap filling plantation estimate
11Details of the trees with their scientific name in RF, Civil Soyam
12II Aligement tree
13Felling of Oak trees
14Certificate of felling minimum trees during the project work
15Muck Disposal
16Certificate of felling minimum trees during the project work
17Whether project area is a part of National Park or sanctuary and airal
18part I
19Part II (DFO)
20Certificate work has not been started reg
21Geologist Report
22Task Force report
23Manak Shartain
24Certificate by user agency for complying the condition imposed in geologist report Task Forcex
25No historical monumental or relegeous place will be effected
26NPV calculation certificate as per Honble Supreem court MoEF
27Undertaking of payment of NPV if Honble Supreem Court increses the rates of NPV
28Check list Fact sheet
29Benefited village
30Eds dated 28-08-2019
31Eds Dated 27-11-2019
32Eds Dated 27-11-2019
33Eds Dated 01-01-2020
34Eds 24-10-2019
35Aerial Distance Certificate
36eds 11-03-2019
37eds dated 20-08-2019
38Eds 07-06-2019