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/147299/2021   (ii). Name of Project for which Forest Land is required : Widening of Existing Road from Ambikapur toRamanujganj 2-Lane/4-Lane Road NH No. 343   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Widening ofExisting Road from Ambikapur to Ramanujganj 2-Lane/4-Lane National Highway 343 in the state of Chhattisgarh   (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) : 92826   (viii). Area of forest land proposed for diversion(in ha.): 102.324   (ix). Non-forest land required for this project(in ha.): 187.544   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : EXECUTIVE ENGINEER PWD NH DIVISION AMBIKAPUR   (ii). Address1 : Executive Engineer PWD , NH Division , Ambikapur   (iii). Address2 : Behind HariManglam Marriage Hall   (iv). State : Chhattisgarh   (v). District : Surguja   (vi). Pin : 497001   (vii). Landmark : Near New Bus Stand   (viii). Email address : nh43exen@gmail.com   (ix). Landline Telephone No. : 7774-222724   (x). Fax No. : 7774-   (xi). Mobile No. : 9993311553   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Nitesh   (ii). Middle Name: Enter Middle Name   (iii). Last Name: Tiwari   (iv). Gender: Male   (v). Designation: EE   (vi). Address 1: Executive Engineer PWD NH Division Ambikapur   (vii). Address 2: Behind HariManglam Marriage Hall   (viii). State: Chhattisgarh   (ix). District: Surguja   (x). Tehsil: Ambikapur   (xi). Pin: 497001   (xii). Landmark: Near New Bus Stand   (xiii). Email Address: nh43exen@gmail.com   (xiv). Landline Telephone No.: 9900-222724   (xv). Fax No.: NIL   (xvi). Mobile No.: 8818849900   (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.Balrampur92.455111.295
2.South Surguja9.86976.249
Total102.324187.544
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Surajpur5.6379.12
1.Surguja4.23267.129
3.Balrampur92.455111.295
Total102.324187.544
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Ajirma5.6370
2Asola01.8
3Badni Jhariya03.149
4Bahafoli05.1
5Bhakura06.3
6Chathirma04.195
7Devgarh03.887
8Hansuli05.1
9Kakna2.8377.363
10Kishunnagar0.2084.741
11Mendra Khurd4.0098.891
12Narayanpur00.47
13Parsa06.299
14Rajpuri Khurd0.0150.597
15Sakalo013.05
16Sanjaynagar05.591
17Sargawa02.966
18Adhura03.9
19Alakhdiha4.4683.974
20Aragahi02.4
21Badkimehri9.7450
22Baghima2.0813.293
23Balrampur0.7354.398
24Bariyon0.5327.387
25Basen9.4055.014
26Bhanuora04.796
27Budha Bagicha0.0110.651
28Bulgaon0.0141.651
29Chanchi4.1724.918
30Chandanpur4.9297.914
31Dakuwa0.0190
32Damodarpur08.178
33Dandkhaduawa6.2381.749
34Devgai2.890
35Jamwantpur0.0254.476
36Jhingo3.6685.482
37Jigari10.2710
38Kamalpur4.2851.81
39Karji08.018
40Lurghuta7.1171.21
41Mahuapara0.1223.116
42Nawki4.7631.834
43Parsagudi1.6133.568
44Pasta0.0016.837
45Purandih0.0033.928
46Ramanujganj01.586
47Semli2.920.401
48Tambeshwarnag04.974
49Tatapani8.670
50Nawapara0.9210.582
Total 102.324 187.544
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1WIDENING OF EXISTING ROAD102.324187.544
Total 102.324 187.544
C. Maps of forest land proposed to be diverted
Division 1. : Balrampur
  (i). Area of forest land proposed to be diverted(in ha.) : 92.455   (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).
1.92.455    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. : South Surguja
  (i). Area of forest land proposed to be diverted(in ha.) : 9.869   (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).
1.9.869    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: Yes   (a). Copy of map indicating location of alternative examined:
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): 50
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?: 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: Five
District 1. : Janjgir - Champa
  (a). Village: JARVE-1   (b). Area(in ha.): 18.249   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 230/1,230/2,257/1   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
District 2. : Janjgir - Champa
  (a). Village: Kosmunda-1   (b). Area(in ha.): 4.98   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 892/1   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
District 3. : Janjgir - Champa
  (a). Village: Borsi   (b). Area(in ha.): 33.698   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 952/1   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
District 4. : Janjgir - Champa
  (a). Village: Kosmunda-2   (b). Area(in ha.): 29.839   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 879   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
District 5. : Janjgir - Champa
  (a). Village: Mudpar   (b). Area(in ha.): 17.612   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 657/1   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
  (v). Scanned copy of the map of the land identified for creation of Compensatory Afforestation prepared by using GPS 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
1Undertaking for Administrative Approval and Technical Senctionea
2Authority letter referenece query no A-3(xvii)
3Balrampur Division Letter
4Surguja Division Letter
5Promissory Note reference to query no B-1
6Demand draft letter and challan copy reference to Add information query no 3
7Revenue forest land letter query no 2 in add information
8Query Reply Letter
9The Gazette of India (Land Acquisition) as a collector NOC for Non forest land
10Bridges and Culverts Detail
11Undertaking for not using Wildlife area
12Promissory letter for NOC of Revenue Forest and Receiving of concerning Collector
13Promissory letter for Certified DGPS
14Query letter 3098 for PCCF
15Hardcopy Submission receipt
16Balrampur Land Classification
17Surguja Division Land Classification
18Surguja Verified and Signed DGPS Report
19Undertaking for CA Land
20NOC from Collector Office Balrampur
21NOC from Collector Office Surguja District
22Receiving letter Regarding submission of hardcopy to DFO ambikapur
23Reply of quarry to DFO Ambikapur
24Submission of FCA Checklist to Ambikapur DFO
25Letter for No forest land fall in Ambikapur Division
26Ambikapur FCA submit Letter receiving in DFO Forest office Balrampur
27Balrampur Verified and Signed DGPS Report
28Geo Map with High resolution 92_455
29Balrampur division Toposheet singed and verified by Forest Personnel with High resolution 92_455
30Balrampur division Toposheet 2 singed and verified by Forest Personnel with High resolution 92_455
31Balrampur division Toposheet 3 singed and verified by Forest Personnel with High resolution 92_455
32Balrampur division Toposheet 4 singed and verified by Forest Personnel with High resolution 92_455
33Balrampur division Toposheet 5 singed and verified by Forest Personnel with High resolution 92_455
34Balrampur division Toposheet 6 singed and verified by Forest Personnel with High resolution 92_455
35Receiving from Forest Office of Balrampur division
36CA Scheme for 11.274
37DGPS Report for 11.274
38Cost Benifit Analysis
39Comparison Of Alignment
40Alternate Alignment toposhhet
41Alternate Alignment toposhhet
42Comparison of Alignment with Toposheet
43Reply letter against EDS by State Government (SG)
44Certificate(Chief Secretary Chhattisgarh ) of Nonavailability of land for Compensatory Afforestation.
45EDS reply to dfo balrampur
46Reply letter against DFO query letter
47GEO-Reference Map of CA Land
48Toposheet Map of CA Land