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/154252/2022
(ii). Name of Project for which Forest Land is required :
Diversion of of P.F. land for access road to Retail Outlet of M/S RBML at Village-Sikandrabad Dehat, Khasra No.- 1440, in Chainage 53.997 on RHS of Ghaziabad-Aligarh Road(NH-34) Tehsil- Sikandrabad, District- Buland Shahr, UP
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
Diversion of of P.F. land for access road to Retail Outlet of M/S RBML at Village-Sikandrabad Dehat, Khasra No.- 1440, in Chainage 53.997 on RHS of Ghaziabad-Aligarh Road(NH-34) Tehsil- Sikandrabad, District- Buland Shahr, UP
(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) :
80
(viii). Area of forest land proposed for diversion(in ha.):
0.0689812
(ix). Non-forest land required for this project(in ha.):
0.2920064
(x). Total period for which the forest land is proposed to be diverted(in years):
30
A-2.
Details of User Agency
(i). Name :
RELIANCE BP MOBILITY LIMITED UP (WEST)
(ii). Address1 :
Petroleum Department, 2nd Floor, Reliance House, RK Four Square, Building No.-4, DLF Cyber City, Phase-2, Gurugram-122002
(iii). Address2 :
NIL
(iv). State :
Haryana
(v). District :
Gurgaon
(vi). Pin :
122002
(vii). Landmark :
NIL
(viii). Email address :
tanuj.jindal@jiobp.com
(ix). Landline Telephone No. :
0-
(x). Fax No. :
0-
(xi). Mobile No. :
8851177480
(xii). Website (if any) :
NIL
(xiii). Legal status of User Agency :
Private
A-3.
Details of Person Making Application
(i). First Name:
Tanuj
(ii). Middle Name:
NIL
(iii). Last Name:
Jindal
(iv). Gender:
Male
(v). Designation:
State Business Development Manager(UP-West & UT)
(vi). Address 1:
Petroleum Department, 2nd Floor, Reliance House, RK Four Square Building no-4, DLF Cyber City Phase-2, Gurugram-122002
(vii). Address 2:
NIL
(viii). State:
Haryana
(ix). District:
Gurgaon
(x). Tehsil:
Gurgaon
(xi). Pin:
122002
(xii). Landmark:
NIL
(xiii). Email Address:
tanuj.jindal@jiobp.com
(xiv). Landline Telephone No.:
562-4003705
(xv). Fax No.:
NIL
(xvi). Mobile No.:
8851177480
(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 Bulandshahar
0.0689812
0.2920064
Total
0.0689812
0.2920064
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Bulandshahr
0.0689812
0.2920064
Total
0.0689812
0.2920064
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
Sikandrabad Dehat
0.0689812
0.290064
Total
0.0689812
0.290064
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Entry to Retail outlet
0.020001
0
2
Exit to Retail Outlet
0.0207426
0
3
Middle Part Between Entry and Exit
0.027435
0
4
Area of Retail Outlet
0
0.2920064
Total
0.0681786
0.2920064
C.
Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Bulandshahar
(i). Area of forest land proposed to be diverted(in ha.) :
0.0689812
(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 Patches
To view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.
0.0689812
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):
15
(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? :
No
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
1
FIRE NOC
2
Gazette Notification
3
Land Documents
4
Nhai Approved plan
5
NHAI NOC LETTER
6
POLUTION NOC
7
LOI
8
pollution NOC
9
Detailed Area Calculation
10
Caculation of NPV Leives
11
certificate of ambiding Rules and standard Conditions
12
Certificate of forest land as per approved layout plan
13
Job not Working Certificate
14
Muck Disposal Plan
15
Standard Condition
16
Undertaking for ETT
17
Undertaking of NPV
18
Undertaking of payement of CA
19
Undertaking regarding FRA Certificate
20
Area conversion Letter
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