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/UP/Approach/153324/2022   (ii). Name of Project for which Forest Land is required : HPCL Retail Outlet on Handia-Prayagraj Road (SH-106) , In KM Stone No.-236 , Ch.235.040 (RHS), At Gata No.106, Village: Sarai Dasu Urf Haripur ,Pargna: Kewai, Tehsil: Handia, District: Prayagraj(UP)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Hindustan Petroleum Corporation Limited Retail Outlet on Handia-Prayagraj Road (SH-106) , In KM Stone No.-236 , Ch.235.040 (RHS), At Gata No.106, Village: Sarai Dasu Urf Haripur ,Pargna: Kewai, Tehsil: Handia, District: Prayagraj (Uttar Pradesh).   (iv). State : Uttar Pradesh   (v). Category of the Proposal : Approach Access   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 45   (viii). Area of forest land proposed for diversion(in ha.): 0.3288   (ix). Non-forest land required for this project(in ha.): 0.1987   (x). Total period for which the forest land is proposed to be diverted(in years): 30
A-2. Details of User Agency
  (i). Name : HINDUSTAN PETROLEUM   (ii). Address1 : 2nd Floor ,North Square, Shastri Nagar,Sigra, Varanasi   (iii). Address2 : NIL   (iv). State : Uttar Pradesh   (v). District : Varanasi   (vi). Pin : 221002   (vii). Landmark : NIL   (viii). Email address : hpcl.banaras@gmail.com   (ix). Landline Telephone No. : 0-   (x). Fax No. : 0-   (xi). Mobile No. : 9703441364   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central PSU
A-3. Details of Person Making Application
  (i). First Name: PRASHANT   (ii). Middle Name: KUMAR   (iii). Last Name: SHUKLA   (iv). Gender: Male   (v). Designation: DEPUTY GENERAL MANAGER   (vi). Address 1: 2nd Floor, North Square, Shastri Nagar, Sigra, Varanasi   (vii). Address 2: NIL   (viii). State: Uttar Pradesh   (ix). District: Varanasi   (x). Tehsil: Varanasi   (xi). Pin: 221002   (xii). Landmark: NIL   (xiii). Email Address: hpcl.banaras@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 9703441364   (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.Social Forestry Division Allahabad0.32880.1987
Total0.32880.1987
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.PRAYAGRAJ0.32880.1987
Total0.32880.1987
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Sarai Dasu Urf Haripur0.32880.1987
Total 0.3288 0.1987
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Entry Exit and Middle Land0.32880.1987
Total 0.3288 0.1987
C. Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Allahabad
  (i). Area of forest land proposed to be diverted(in ha.) : 0.3288   (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.
1.0.3288    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): 5   (iii). Temporary Employment(Number of person-days): 500
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
1Area Calculation Sheet
2ETT
3FIRE NOC
4Khatauni
5LEASE AGREEMENT
6LOI Letter
7POLLUTION NOC
8कार्य प्रारम्भ न करने का प्रमाण पत्र
9दण्डात्मक वृक्षारोपण हेतु वचनबद्धता प्रमाण पत्र
10प्रतिपूरक वनीकरण करने सम्बन्धी वचनबद्धता प्रमाण पत्र
11प्रभावित वन भूमि का शुद्ध वर्तमान मूल्य (एनoपीoवीo) के भुगतान किये जाने सम्बन्धी प्रमाण पत्र
12प्रस्तावित वन भूमि के एनoपीoवीo के संशोधन के उपरांत बढ़ी हुई धनराशि के भुगतान की वचनबद्धता प्रमाण पत्र
13मक डिस्पोजल प्रमाण पत्र
14मानक शर्ते
15PWD NOC
16Layout Plan With NOC
17Kam se kam vriksho ka patan
18Forest Notification