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/RJ/ROAD/20446/2016   (ii). Name of Project for which Forest Land is required : EXISTING IOCL RETAIL OUTLET AT KHASRA NO 898(OLD 734/2) , SH-60 (OLD SH-18), VILLAGE BHERUNDA , TEHSIL DEGANA , DISTRICT- NAGAUR   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : PROPOSAL FOR DIVERSION OF PROTECTED STRIP OF FOREST TO APPROACH ROAD FOR THE EXISTING RETAIL OUTLET AT KHASRA NO 898 (OLD 734/2) AT VILLAGE BHERUNDA , THESIL DEGANA , DISTRICT - NAGAUR NEAR KM STONE NO.38 ON SH-60(OLD SH-18), Bherunda-Ajmer Road LHS   (iv). State : Rajasthan   (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) : 75   (viii). Area of forest land proposed for diversion(in ha.): 0.0413   (ix). Non-forest land required for this project(in ha.): 0.2091   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : IOCL FCA PROPOSALS   (ii). Address1 : E-83, Shastri Nagar, Lohagal Road, Ajmer, Rajasthan   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Ajmer   (vi). Pin : 305006   (vii). Landmarks : NIL   (viii). Email address : ioclproposalsfca@gmail.com   (ix). Landline Telephone No. : 2632343   (x). Fax No. : NIL   (xi). Mobile No. : 9414040305   (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  
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
1ApprovedFP/RJ/ROAD/15786F.1(94)Forest/20150.12020.120227 Nov 201510 Mar 2016
2ApprovedFP/RJ/ROAD/14567/2015F.1(103)forest/20150.1278050.12780517 Dec 201503 Mar 2016
Total 0.248005 0.248005
  (xiv). Legal status of User Agency : Central PSU
A-3. Details of Person Making Application
  (i). First Name: Sanjiv   (ii). Middle Name: Kumar   (iii). Last Name: Goyal   (iv). Gender: Male   (v). Designation: Deputy Manager Retail Sales   (vi). Address 1: E-83, Shastri Nagar, Lohagal Road, Ajmer, Rajasthan   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Ajmer   (x). Tehsil: NIL   (xi). Pin: 305006   (xii). Landmarks: NIL   (xiii). Email Address: ioclproposalsfca@gmail.com   (xiv). Landline Telephone No.: 2632343   (xv). Fax No.: NIL   (xvi). Mobile No.: 9414040305   (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.Nagaur Territorial0.04130.2091
Total0.04130.2091
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Nagaur0.04130.2091
Total0.04130.2091
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Bherunda0.04130.2091
0.0413 0.2091
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Acceleration Lane0.020650
2Deceleration Lane0.020650
3Non Forest Area00.2091
Total 0.0413 0.2091
C. Maps of forest land proposed to be diverted
Division 1. : Nagaur Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.0413   (ii).Shape of forest land proposed to be diverted : Linear   (b). No. of Segments : Two
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.
1.0.02065    View File
2.0.02065    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: THERE IS ONLY ONE APPROACH FOR THE PROPOSED SITE
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 4   (iii). Temporary Employment(Number of person-days): 10
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?: 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
1Certificate under FRA 2006
2LETTER OF APPOINTMENT ISSUED BY IOCL.
3UNDERTAKING FOR PENAL COMPENSATORY AFFORESTATION.
4Khasra Map.
5Bar Chart Showing the Required Forest AND Non Forest Land Status.
6MAP SHOWING DIGITAL MAP OF REQUIRED FOREST LAND AND COORDINATES OF PROPOSED ROAD ALIGNMENT.
7Map Showing Geo referenced Survey of India Toposheet With Forest Land Boundary AND Proposed Road Alignment.
8MAP SHOWING GOOGLE IMAGERY WITH FOREST LAND BOUNDARY and PROPOSED ROAD ALIGNMENT.
9Map Showing Zoom View Of Geo referenced Survey of India Toposheet With Forest Land Boundary AND Proposed Road Alignment.
10JAMABANDI OF PROPOSED SITE
11APPROVED LAYOUT PLAN FROM DM NAGAUR & PWD
12PWD NOC
13JUSTIFICATION
14UNDERTAKING FOR FLORA & FAUNA
15UNDERTAKING FOR NO OTHER ALTERNATIVE LAND
16UNDERTAKING FOR USE OF FOREST LAND
17UNDERTAKING FOR PAYMENT OF COST & CONDITION
18UNDERTAKING FOR NPA
19UNDERTAKING FOR NO CHANGE IN STATUTORY POSITION
20UNDERTAKING FOR COMPENSATORY AFFEROSETATION
21NOC BY DM NAGAUR
22AREA CALCULATION SHEET UPDATED
23COMMERCIAL LAND CONVERSION ORDER
24Request Letter to Change the Name of user Agency.
25LETTER FOR CERTIFICATE UNDER FRA 2006
26CLARIFICATION FOR DIVERSION
27UNDERTAKING FOR COMPENSATORY REFORESTATION