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/CG/ROAD/12117/2015   (ii). Name of Project for which Forest Land is required : Ambikapur to Pathalgaon,NH-78   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : widening and upgrading of NH-78 to 2-Lane with Paved shoulder from Ambikapur to Pathalgaon.   (iv). State : Chhattisgarh   (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) : 47500   (viii). Area of forest land proposed for diversion(in ha.): 31.104   (ix). Non-forest land required for this project(in ha.): 85.0849   (x). Total period for which the forest land is proposed to be diverted(in years): NIL
A-2. Details of User Agency
  (i). Name : Public Works Department National Highway Zone Chhattisgarh   (ii). Address1 : Office of the Chief Engineer, Public Works Department, National Highway Zone   (iii). Address2 : NIL   (iv). State : Chhattisgarh   (v). District : Raipur   (vi). Pin : 492001   (vii). Landmark : Pentionwada   (viii). Email address : cenhr@rediffmail.com   (ix). Landline Telephone No. : 771-4051075   (x). Fax No. : NIL   (xi). Mobile No. : 9425229555   (xii). Website (if any) : http://cg.nic.in/pwdraipur/   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Kamlesh   (ii). Middle Name: Kumar   (iii). Last Name: Pipri   (iv). Gender: Male   (v). Designation: Chief Engineer   (vi). Address 1: Office of the Chief Engineer, Public Works Department, National Highway Zone Pension Bada Raipur   (vii). Address 2: NIL   (viii). State: Chhattisgarh   (ix). District: Raipur   (x). Tehsil: Raipur   (xi). Pin: 492001   (xii). Landmark: Pension Bada   (xiii). Email Address: cenhr@rediffmail.com   (xiv). Landline Telephone No.: 771-4051075   (xv). Fax No.: NIL   (xvi). Mobile No.: 7999844631   (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
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
1InprincipleFP/CG/ROAD/18290/2011FC-III/CH-7/2016-NGP/942192.546192.54613 Oct 2016
Total 192.546 192.546
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.Surajpur7.1857.2475
2.Surguja Forest Division Ambikapur23.07757.6278
3.Jashpur0.84220.2096
Total31.10485.0849
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Surajpur7.1857.2475
1.Surguja23.07757.6278
3.Jashpur0.84220.2096
Total31.10485.0849
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Sanjay Nagar00.13
2MAHAVEERPUR1.6053.9234
3AAMGAON5.583.1941
4SANDBAR7.0911.34
5LAXMINAGAR7.594.7324
6MANIPUR03.0259
7PACHPEDI05.8672
8KANTIPRAKASHPUR0.357.1901
9SHRIGARH00.3
10LAAMGAON6.5711.2934
11KOT1.371.1232
12SARASWATIPUR01.817
13SELMA00.318
14SEDAM0.1050.355
15SUWARPARA00.83
16KARABEL06.2475
17BAMLAYA00.424
18SONTARAI03.486
19SITAPUR010.57
20SUR01.279
21CHALTA00.251
22PRATAPGARH01.437
23RADHAPUR02.9101
24DEVGARH00.032
25GUTURMA02.218
26HARRATIKRA00.581
27RARUMAKALA0.1863.4143
28KERAKACHAR0.1844.312
29KARMITIKRA0.471991.368
30GODHIKALA01.234
31MADANPUR01.085
32BANDHIYAKHAR01.9043
33PATHALGAON06.754
34PALIDIH00.138
Total 31.10399 85.0849
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road31.10485.0849
Total 31.104 85.0849
C. Maps of forest land proposed to be diverted
Division 1. : Surguja Forest Division Ambikapur
  (i). Area of forest land proposed to be diverted(in ha.) : 23.077   (ii). Nature of the Project: Linear   (b). No. of Segments : Nine
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).
1.7.091    View File
2.7.59    View File
3.0.35    View File
4.1.68    View File
5.4.051    View File
6.0.84    View File
7.1.3    View File
8.0.07    View File
9.0.105    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:
Division 2. : Surajpur
  (i). Area of forest land proposed to be diverted(in ha.) : 7.185   (ii). Nature of the Project: Linear   (b). No. of Segments : Four
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).
1.0.48    View File
2.0.06    View File
3.1.125    View File
4.5.52    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:
Division 3. : Jashpur
  (i). Area of forest land proposed to be diverted(in ha.) : 0.842   (ii). Nature of the Project: Linear   (b). No. of Segments : Three
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).
1.0.186    View File
2.0.184    View File
3.0.472    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: The existing NH 78 already passes through the fore
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 7300   (iii). Temporary Employment(Number of person-days): 73000
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 ? : 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?: No   (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) . Reason for not providing Non-Forest Land: Certificate from Chief Secretary regarding non-availability of suitable non-forest/ revenue forest land
Additional information Details
Documents
S.No Documents
Remarks
1NOC FROM COLLECTOR SURAJPUR FOR REVENUE FOREST LAND.
2NOC FROM COLLECTOR, JASHPUR FOR REVENUE FOREST LAND.
3FOREST AREA DETAIL
4Registration Fee
5PROCESSING FEE
6Justification for the point raised in EDS on dated 18 Aug 2015
7Justification for the point raised in EDS on dated 12th Sept