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/GJ/Others/31388/2018   (ii). Name of Project for which Forest Land is required : Tiger Interpretation Safari Park, Narmada   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Tiger Interpretation Safari Park will be developed in three parts in a 64 ha of RF in Tilakwada Taluka of Kevadiya Range, Narmada forest division. The prime Objective of this interpretation zone and safari park is to develop ecotourism facility in Narmada district to encourage ecotourism and awarene   (iv). State : Gujarat   (v). Category of the Proposal : Others   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 2154.44   (viii). Area of forest land proposed for diversion(in ha.): 64   (ix). Non-forest land required for this project(in ha.): 0   (x). Total period for which the forest land is proposed to be diverted(in years): NIL
A-2. Details of User Agency
  (i). Name : DCFNARMADA   (ii). Address1 : office of the dcf, mear vadia jakat naka, narmada forest division, rajpipla   (iii). Address2 : NIL   (iv). State : Gujarat   (v). District : Narmada   (vi). Pin : 393145   (vii). Landmark : Vadia Palace   (viii). Email address : dcfnarmada@gmail.com   (ix). Landline Telephone No. : 2640-220013   (x). Fax No. : 2640-222013   (xi). Mobile No. : 9978203219   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: K   (ii). Middle Name: NIL   (iii). Last Name: Sasikumar   (iv). Gender: Male   (v). Designation: DCF   (vi). Address 1: office of the dcf, mear vadia jakat naka, narmada forest division, rajpipla   (vii). Address 2: NIL   (viii). State: Gujarat   (ix). District: Narmada   (x). Tehsil: Nandod   (xi). Pin: 393145   (xii). Landmark: Vadia Palace   (xiii). Email Address: dcfnarmada@gmail.com   (xiv). Landline Telephone No.: 2640-220013   (xv). Fax No.: 02640222013   (xvi). Mobile No.: 9978203219   (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.Narmada640
Total640
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Narmada640
Total640
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1kakadiya640
Total 64 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Tiger safari640
Total 64 0
C. Maps of forest land proposed to be diverted
Division 1. : Narmada
  (i). Area of forest land proposed to be diverted(in ha.) : 64   (ii). Nature of the Project: Non Linear   (a). No. of patches : One
Patch wise details
Patch No. Area of Patch(in ha.) Kml File of PatchesTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.64    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:
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 30   (iii). Temporary Employment(Number of person-days): 24000
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: No Data
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 ?: Yes   (a). Reason Category: CA Will be raised on degraded forest land as well as on land provided by User Agency   (b). Degraded forest area on which CA has to be raised by forest department(in ha.): 20   (c). Area of non-forest or Revenue forest land required to be provided by User Agency for raising Compensatory Afforestation(in ha.): NIL   (iii) . Reason for not providing Non-Forest Land: Others
Additional information Details
Documents
S.No Documents
Remarks
1Clarification on NPV and CA
2Project note
3Cost Benefit analysis
4Cost Benefit analysis 2
5Stetement Non Forest area
6Stetement Forest area
7justification of proposal
8minimum use of forest land
9payment of cost of CA
10payment of NPV
11undertaking additional condition
12Environmental clearance
13site inspection report
14Gazette Notofication
15Location map of CA land
16Scheme of plantation on CA
17Certificate non forest land selected
18Land suitability certificate by DCF
19Certificate No violation of FCA
20Certificate no violation of FCA person
21Certificate distance historical places
22Certificate distance from PA
23Certificate of court case
24Certificate of DCF about over lapping
25Certificate The MAP (village Map)
26Certificate Index map
27Geomap CA
28Geomap of Project
29Alternate route for linear diversion
30Certificate for Expansion of linear project
31Layout Plan
32Geomap
33Alternative route
34DEMAND LETTER