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/WATER/36565/2018   (ii). Name of Project for which Forest Land is required : Balance work of cluster scheme of 315 villages of Mandalgarh, Bijoliya and Jahajpur Tehsils along with Augmentation of UWSS of mandalgarh and Bijoliya Towns from Aroli Headworks under Chambal-Bhilwara   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Balance work of cluster scheme of 315 villages of Mandalgarh, Bijoliya and Jahajpur Tehsils along with Augmentation of UWSS of mandalgarh and Bijoliya Towns from Aroli Headworks under Chambal-Bhilwara Water Supply Project Phase-II, Package-VIII of District Bhilwara (Raj.)   (iv). State : Rajasthan   (v). Category of the Proposal : Drinking Water   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 327.45   (viii). Area of forest land proposed for diversion(in ha.): 2.0467   (ix). Non-forest land required for this project(in ha.): 42.836   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : PUBLIC HEALTH ENGINEERING DEPARTMENT   (ii). Address1 : office of the superintending engineer, PHED, Project circle-I Bhilwara   (iii). Address2 : PHED Campus, Bapu Nagar, Bhilwara   (iv). State : Rajasthan   (v). District : Bhilwara   (vi). Pin : 311001   (vii). Landmarks : NIL   (viii). Email address : phedmandalgarh18@gmail.com   (ix). Landline Telephone No. : 240330   (x). Fax No. : NIL   (xi). Mobile No. : 8890877722   (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 : State Government
A-3. Details of Person Making Application
  (i). First Name: Bhagwan   (ii). Middle Name: Swaroop   (iii). Last Name: Naklak   (iv). Gender: Male   (v). Designation: ExecutiveEngineer   (vi). Address 1: office of the Executive Engineer PHED   (vii). Address 2: Project Division Mandalgarh   (viii). State: Rajasthan   (ix). District: Bhilwara   (x). Tehsil: Mandalgarh   (xi). Pin: 311604   (xii). Landmarks: NIL   (xiii). Email Address: phedmandalgarh18@gmail.com   (xiv). Landline Telephone No.: 240330   (xv). Fax No.: NIL   (xvi). Mobile No.: 8890877722   (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.Bhilwara Territorial2.046742.836
Total2.046742.836
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bhilwara2.046742.836
Total2.046742.836
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Chandpura0.0471.105
2Ummedpura0.00822.85
3Duda ji Ka Khera0.01544.235
4Takhatji ka Khera0.0480.905
5Kham ka Khera0.11491.102
6Shyampura0.04184.02
7Hameeriya0.05161.084
8Banka0.22361.5385
9Lorda0.121.485
10Sunthi0.1611.205
11Teekhi0.32630.9075
12Ramrada0.08391.2055
13Phoolan0.02611.907
14Mangarh0.12541.002
15Patiyal0.0681.105
16Chhatrikhera khurd0.01043.312
17Brindavan0.06410.8025
18Kaner0.03540.96
19Karlao0.06060.9905
20Bhopalgarh0.0122.308
21Fatehpura0.07770.8044
22Anando ka khera0.06491.9375
23Mohanpura0.07281.104
24Neem ka khera0.04192.812
25Bharji ka khera0.04970.1596
26Kekariya0.09591.989
2.0466 42.836
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying of Pipeline2.046738.7835
2Pump House00.24
3ESR03.8125
Total 2.0467 42.836
C. Maps of forest land proposed to be diverted
Division 1. : Bhilwara Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 2.0467   (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.
1.2.0467    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: Pipelines is Proposed along the road.
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 3   (iii). Temporary Employment(Number of person-days): 350
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   (v). Scanned copy of the map of the land identified for creation of Compensatory Afforestation prepared by using DGPS 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
1Proposed Pipeline Cross Section.
2EDS Reply Letter.
3CERTIFICATE FOR MINIMUM USE OF FOREST LAND.
4UNDERTAKING FOR CONSERVATION OF FLORA FAUNA DURING Pipeline.
5Undertaking for Muck Disposal Plan.
6UNDERTAKING FOR NO CHANGE_S IN STATUTORY POSITION OF DIVERTED FOREST LAND.
7UNDERTAKING FOR NO OTHER FEASIBLE ALTERNATIVE.
8UNDERTAKING FOR PAYMENT OF ANY OTHER COST AND CONDITION.
9UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION.
10UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA.
11Undertaking for Use of Any Material From Forest Land.
12UNDERTAKING FOR USE OF FOREST LAND.
13Component Wise Area Calculation Sheet.
14Segment Wise Area Calculation Sheet.
15Village Wise and segment wise Area Calculation Sheet with segment.
16Khasra Map and jamabandi.
17Bar Chart Status.
18Georeferenced Zoom View Digital Map with Coordinates Segment 1 and 19.
19Georeferenced Toposheet Map Total Alignment 50000 scale.
20Georeferenced Digital Map Total Alignment 50000 scale.
21Equal Non Forest Land Allotment Consent Letter.
22FRA Certificate.
23EDS Reply of 14.08.2019 EDS.
24Administrative and Financial Sanctions.
25Project Report.
26Khasra Map new Additional.