FORM - B
Form for seeking prior approval under Section-2 of the proposals by the State Governments and other authorities, in respect of renewal of leases,
which have been earlier granted clearance under Forest (Conservation) Act,1980
PART - I
(To be filled up by User Agency)
A. General Details
A-1. Project Details
  (i). Proposal No. : FP/PB/Pipeline/157031/2022   (ii). Name of Project for which Forest Land is required : Laying of Proposed 8” & 12” Dia. Steel Gas Pipeline Along & Across various Asphalt Road & Amloh Minor Canal from Chanakya Dairy to Baronga CGS Connectivity to developing City Gas distribution network   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Laying of proposed 8” & 12” Dia Steel Gas Pipeline Along & Across various Asphalt Road & Amloh Minor Canal from Chanakaya Dairy to Barounga CGS Connectivity to developing City Gas distribution network in Mandi Gobindgarh City under Fatehgarh Sahib GA.   (iv). State : Punjab   (v). Category of the Proposal : Pipeline   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 700   (viii). Area of forest land proposed for diversion(in ha.): 0.44   (ix). Non-forest land required for this project(in ha.): 0   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : IRM ENERGY PRIVATE LIMITED   (ii). Address1 : IRM House, Kalpana Society, Nr. Sardar Sewa Samaj, Off. C.G. Road, Navrangpura, Ahmedabad-380009   (iii). Address2 : NIL   (iv). State : Gujarat   (v). District : Ahmedabad   (vi). Pin : 380009   (vii). Landmarks : NIL   (viii). Email address : prashant.sagar@irmenergy.com   (ix). Landline Telephone No. : 26562615   (x). Fax No. : NIL   (xi). Mobile No. : 9512490051   (xii). Website (if any) : NIL   (xiii). Details of Proposals seeking prior approval of Central Government under the Act for diversion of forest land submitted by the User Agency 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
  (xiv). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Prashant   (ii). Middle Name: NIL   (iii). Last Name: Sagar   (iv). Gender: Male   (v). Designation: Executive Vice President - Projects   (vi). Address 1: IRM Energy Limited, 4th Floor, 8th Block, Magnet Corporate Park, Near Sola Bridge, S.G. Highway, Thaltej, Ahmedabad - 380054   (vii). Address 2: NIL   (viii). State: Gujarat   (ix). District: Ahmedabad   (x). Tehsil: Ahmedabad City   (xi). Pin: 380054   (xii). Landmarks: NIL   (xiii). Email Address: prashant.sagar@irmenergy.com   (xiv). Landline Telephone No.: 26562615   (xv). Fax No.: NIL   (xvi). Mobile No.: 9512490051   (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:
A-7. Details of the forest land returned back to the State Forest Department or any other Authority from the forest land diverted in favour of the user agency
A-9. Details of Transfer of Lease
Serial No Name of person Address of person Date of transfer MMDR File Transfer Deed Conservation MoEF_file No Date of approval MoEF file
NIL
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
  (i). Whether any proposal seeking prior approval of Central Government under the Act for diversion of forest land required for the project has been submitted in the past?. : No
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.Patiala0.440
Total0.440
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Fatehgarh Sahib0.440
Total0.440
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Ajnali0.05190
2Ambe Majra0.00180
3Chattarpur0.07430
4Kumbhra0.20840
5Baronga Buland0.10360
0.44 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Along Asp. Rd (Chanakya Dairy to Amloh Minor Canal0.05130
2Across Asp. Rd Near Canal0.00060
3Across Amloh Minor Canal0.00180
4Along Amloh Minor Canal0.07430
5Along Amloh Minor Canal 10.20840
6Along Baronga Gram Panchayat Road to Badali Road0.10360
Total 0.44 0
C. Maps of forest land proposed to be diverted
Division 1. : Patiala
  (i). Area of forest land proposed to be diverted(in ha.) : 0.44   (ii).Shape of forest land proposed to be diverted : Linear   (b). No. of Segments : One
Segments wise details
Segmenst Segment Area(in ha.) Kml File of SegmentsTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0.44    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 DGPS 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: No   (a). Reason for not providing such map: NIL
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): 5
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?: NIL   (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 ?: NIL   (iii) . Reason for not providing Non-Forest Land: NIL
Additional information Details
Documents
S.No Documents
Remarks
1Compliance Regarding Green Punjab Mission Fees, Processing Fee and BG enclosed herewith
2Green Punjab Mission Fees Challan enclosed herewith
3Processing Fees Challan enclosed herewith
4Bank Guarantee enclosed herewith
5Undertaking for CA (Annexure-11) Enclosed Herewith
6Undertaking for NPV (Annexure-12) Enclosed Herewith
7Undertaking for NPV Govt/Public Welfare Project (Annexure-13) Enclosed Herewith
8Undertaking for Add. NPV Enclosed Herewith
9Undertaking for Pvt-Govt Premises Enclosed Herewith
10Undertaking for Clarification Govt-Pvt Project Enclosed Herewith
11Undertaking for FRA Enclosed Herewith
12Undertaking for Pipeline Depth Enclosed Herewith
13Undertaking for CNG Pipeline Enclosed Herewith
14Undertaking for NOC Enclosed Herewith
15Undertaking for Reserve Price of Trees Enclosed Herewith
16Layout Plan Drawing with Forest Area Calculation Enclosed Herewith
17Item wise Breakup Annexure A Enclosed Herewith
18Fatehgarh Sahib PNGRB Authorization Enclosed Herewith
19Authorization of Prashant Sagar Enclosed Herewith
20Upload Detailed Note Herewith
21Compliance Report enclosed herewith
22RFO Report enclosed herewith
23Undertaking regarding pipeline width enclosed herewith
24Forest Form A, Part-1 enclosed herewith with signed and stamped
25Compliance Letter enclosed herewith
26Layout Plan enclosed herewith
27Undertaking enclosed herewith