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/BR/ROAD/149739/2021
(ii). Name of Project for which Forest Land is required :
Consultancy Services for Preparation of DPR for Two laning with paved shoulder of Ghazipur – Ballia - UP/Bihar Greenfield section from Km. 0.000 to 115.200 of NH-19 including Buxar Spur (Length:17.800
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
Consultancy Services for Preparation of DPR for Two laning with paved shoulder of Ghazipur – Ballia - UP/Bihar Greenfield section from Km. 0.000 to 115.200 of NH-19 including Buxar Spur (Length:17.800 Km) in the State of Uttar Pradesh
(iv). State :
Bihar
(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) :
91587
(viii). Area of forest land proposed for diversion(in ha.):
5.66
(ix). Non-forest land required for this project(in ha.):
8.385
(x). Total period for which the forest land is proposed to be diverted(in years):
100
A-2.
Details of User Agency
(i). Name :
NATIONAL HIGHWAY AUTHORITY OF INDIA PIU AZAMGARH
(ii). Address1 :
National Highway Authority of India,PIU 20/104,1st Floor,Harbanspur,Azamgarh(UP)
(iii). Address2 :
NIL
(iv). State :
Uttar Pradesh
(v). District :
Azamgarh
(vi). Pin :
276001
(vii). Landmark :
NIL
(viii). Email address :
piuazamgarh@gmail.com
(ix). Landline Telephone No. :
5462-260117
(x). Fax No. :
5462-260117
(xi). Mobile No. :
7860563333
(xii). Website (if any) :
NIL
(xiii). Legal status of User Agency :
Central Government
A-3.
Details of Person Making Application
(i). First Name:
Pradeep
(ii). Middle Name:
Kumar
(iii). Last Name:
Srivastava
(iv). Gender:
Male
(v). Designation:
PD
(vi). Address 1:
Project Implementation Unit.20/104, 1st Floor,Harbanspur,Azamgarh UP
(vii). Address 2:
NIL
(viii). State:
Uttar Pradesh
(ix). District:
Azamgarh
(x). Tehsil:
Azamgarh
(xi). Pin:
276001
(xii). Landmark:
NIL
(xiii). Email Address:
piuazamgarh@nhai.org
(xiv). Landline Telephone No.:
5462-260117
(xv). Fax No.:
05462260117
(xvi). Mobile No.:
9936101899
(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.
Saran
5.66
8.385
Total
5.66
8.385
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Saran
5.66
8.385
Total
5.66
8.385
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
Manjihi
0
5.462
2
Sahabalpur
5.66
2.923
Total
5.66
8.385
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Road
5.66
8.385
Total
5.66
8.385
C.
Maps of forest land proposed to be diverted
Division 1. : Saran
(i). Area of forest land proposed to be diverted(in ha.) :
5.66
(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.
5.66
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:
Forest patches are present in the ROW of the exist
E.
Employment likely to be generated
(i). Whether the Project is likely to generate employment ?:
Yes
(ii). Permanent/Regular Employment(Number of persons):
25
(iii). Temporary Employment(Number of person-days):
800
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?:
Yes
(a). Copy of Cost-Benefit analysis:
H.
Status of Environmental Clearance
(i). Whether the Project requires Clearance under the Environment (Protection) Act 1986 ? :
Yes
(a). Status of the Environmental Clearance to the Project:
EC under process
(ii). Environmental Clearance File No.:
10/43/2021-IA.III
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
Document verification certificate
2
Checklist
3
Form -A
4
Compensatory Afforestation Cost
5
To bear the cost of NPV
6
To bear the additional cost of NPV if any
7
Cost of exploitation of tree growth
8
Bearest Minimum forest land for the project
9
To comply with any other condition by the forest department
10
Archaeological importance certificate
11
To demarcate the forest land as part of the project cost
12
No alternative is possible
13
Cost Benefit analysis of the entire project
14
No labor camp inside the forest
15
No violation of FC Act is committed
16
No work in non forest area will be started
17
Submission of FRA certificate
18
Topo sheet G45M9
19
Index Map of the project road
20
Typical Cross sections of the proposed road
21
Enlarged section of the topo sheet
22
Cross Section
23
Topomap Sing. DFO
24
Land detail Sing. DFO
25
Village Map
26
Compliance letter
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