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/AP/ROAD/146577/2021   (ii). Name of Project for which Forest Land is required : Rehabilitation and up-gradation of National Highway-565 from Km 133.922 to Km 154.900 (Davupally to Mallapalem Junction) to two lanes with paved shoulders in the state of Andhra Pradesh u   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Rehabilitation and up-gradation of National Highway-565 from Km 133.922 to Km 154.900 (Davupally to Mallapalem Junction) to two lanes with paved shoulders in the state of Andhra Pradesh under NHDP- IV   (iv). State : Andhra Pradesh   (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) : 25872   (viii). Area of forest land proposed for diversion(in ha.): 38.6   (ix). Non-forest land required for this project(in ha.): 6.73   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : MINISTRY OF ROAD TRANSPORT AND HIGHWAYS-RO-VIJAYAWADA   (ii). Address1 : Regional office - MoRTH, Amerecan Hospital road, Punammathota, Nehrunagar, Vijayawada, AP   (iii). Address2 : NIL   (iv). State : Andhra Pradesh   (v). District : Krishna   (vi). Pin : 520002   (vii). Landmark : American Hospital road   (viii). Email address : nh56520.978@gmail.com   (ix). Landline Telephone No. : 0-   (x). Fax No. : 0-   (xi). Mobile No. : 9440818290   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: shrawan   (ii). Middle Name: kumar   (iii). Last Name: singh   (iv). Gender: Male   (v). Designation: Regional officer   (vi). Address 1: american hospital road, Punnamathota, Nehrunagar,Vijayawada   (vii). Address 2: NIL   (viii). State: Andhra Pradesh   (ix). District: Krishna   (x). Tehsil: Vijayawada (Urban)   (xi). Pin: 520002   (xii). Landmark: american hospital road   (xiii). Email Address: nh56520.978@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 9440818290   (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.Markapur (WLM)38.66.73
Total38.66.73
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Guntur17.50
1.Prakasam21.16.73
Total38.66.73
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Sirigiripadu beat24.840
2Mallapalem beat8.710
3Komarolu beat20.456.73
Total 54 6.73
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
16313.90
2646.520
3654.420
41841.530
51830.560
61826.620
71726.570
81739.560
91700.410
101692.470
111741.440
Total 54 0
C. Maps of forest land proposed to be diverted
Division 1. : Markapur (WLM)
  (i). Area of forest land proposed to be diverted(in ha.) : 54   (ii). Nature of the Project: Linear   (b). No. of Segments : One
Segment wise details
Segments Segment Area(in ha.) Kml File of Segments
(To view KML file on google the same may be downloaded and then open if in google earth install in your computer).
1.54    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:   (ii). Whether a copy of map indicating location of alternative examine is required to be provided: No   (a). Reason for not providing such map: Not Applicable
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 100   (iii). Temporary Employment(Number of person-days): 210
F. Displacement of People due to the Project, if any
  (i). Whether Project involves displacement?: Yes   (a). Total Number of families : 14   (b). Number of Scheduled Caste families : NIL   (c). Number of Schedule Tribes families : NIL   (d). Number of other families : 14   (ii). Copy of Rehabilitation and Resettlement Plan:   (a). Copy of approval to Ministry of Tribal Affairs,Government of India to Rehabilitation and Resettlement:
G. Details of Cost-Benefit analysis for the Project
  (i). Whether the Project requires Cost-Benefit analysis?: Yes   (a). Copy of Cost-Benefit analysis:
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? : Yes   (a). Whether Project or a part thereof is located within a Protected Area ? : No   (ii). Status of approval of the Standing Committee of National Board for the Wildlife(NBWL) to the Project : Application under process   (a). Date of submission of proposals : 31 Aug 2021   (b). Current status : NIL
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
1Maps for CA land
2Replies for the quarries
3Biodiversity Impact Assessment Report as per the quarries raised by DFO (WL), Markapur letter no Rc.No 1484/2017/DM, Dated 26.08.2022
4Check list of the proposal
5Form A- Part-1 to Part-5.
6Administrative or technical approval
7Detailed Note on the Project
8Map of the Project site, forest area demanded on Original Survey of India Topo-Sheet in 1:50,000
9Geo-referenced digital Map
10DGPS survey document
11wildlife Boundary map
12Statement Showing the details of Forest area
13Item-wise breakup of the forest area proposed for diversion,
14Cost Benefit Analysis
15Minimum Distance of the proposed site from the Wildlife Sanctuary and/or National Park
16Detailed Scheme for Rehabilitation
17Status of Clearance under Environment (Protection) Act, 1986 & Rules 2006;
18Full justification for locating the project in Forest Area
19Certificate for minimum use of Forest land
20Certificate by the project authority that no violation
21Certificate for Compensatory Afforestation Scheme
22Certificate by the Project Authority to furnish the Net Present Value as per the G0I letter F.No.5-3/2007/-FC, Dt.05/02/2009
23Certificate by Project Authority for the cost of Compensatory Afforestation.
24Certificate of Collector under the FRA-2006
25All the certificate and documents must have name of the signatory
26Resolution of the Gram Sabha