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/ROAD/25954/2017   (ii). Name of Project for which Forest Land is required : Rehabilitation and up-gradation of Mahuva- Savarkundla- Amreli- Bagasara-Jetpur section of NH-351 to two/four lane with paved shoulder configuration in the State of Gujarat   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : "Diversion of Forest land for rehabilitation and up-gradation of Mahuva- Savarkundla- Amreli- Bagasara-Jetpur section of NH-351 to two/four lane with paved shoulder configuration in the State of Gujarat".   (iv). State : Gujarat   (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) : 152685   (viii). Area of forest land proposed for diversion(in ha.): 112.736   (ix). Non-forest land required for this project(in ha.): 58.636   (x). Total period for which the forest land is proposed to be diverted(in years): NIL
A-2. Details of User Agency
  (i). Name : EXECUTIVE ENGINEER NATIONAL HIGHWAY DIVISION   (ii). Address1 : Office of the Executive Engineer, National Highway Division, Dr. Rajendr Prasad Road, Rajkot   (iii). Address2 : NIL   (iv). State : Gujarat   (v). District : Rajkot   (vi). Pin : 360001   (vii). Landmark : Nr. Kashi Vishvanath Temple   (viii). Email address : eenhdivisionrajkot@gmail.com   (ix). Landline Telephone No. : 281-2446605   (x). Fax No. : 281-   (xi). Mobile No. : 9409302980   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Ravindra   (ii). Middle Name: N   (iii). Last Name: Mathur   (iv). Gender: Male   (v). Designation: ExecutiveEngineer   (vi). Address 1: Office of Executive Engineer, National Highway Division,Dr. rajendra Prasad Road, Rajkot   (vii). Address 2: NIL   (viii). State: Gujarat   (ix). District: Rajkot   (x). Tehsil: Rajkot   (xi). Pin: 360001   (xii). Landmark: Near Kashi Vishwanath Temple   (xiii). Email Address: eenhdivisionrajkot@yahoo.com   (xiv). Landline Telephone No.: 281-2446605   (xv). Fax No.: NIL   (xvi). Mobile No.: 9409302980   (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.Amreli SF77.12458.636
2.Bhavnagar SF35.6120
Total112.73658.636
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Amreli77.12458.636
1.Bhavnagar35.6120
Total112.73658.636
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
NIL
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Km0.0 to Km29.035.6120
2km 52.072 to km 146.71177.12458.636
Total 112.736 58.636
C. Maps of forest land proposed to be diverted
Division 1. : Amreli SF
  (i). Area of forest land proposed to be diverted(in ha.) : 77.124   (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).
1.77.124    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. : Bhavnagar SF
  (i). Area of forest land proposed to be diverted(in ha.) : 35.612   (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).
1.35.612    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 road has to developed
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 0   (iii). Temporary Employment(Number of person-days): 3000
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? : 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?: 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: Linear or 'strip' plantation declared as protected forest along with road/rail/canal sides for widening or expansion of road/rail/canal
Additional information Details
Documents
S.No Documents
Remarks
1Registration fee and processing fee (Amreli)
2Registration fee and processing fee (Botad)
3Acknowledgement Slip
4Area Calculation Sheet Amreli
5Authority Letter
6Certificate for Minimum Use of Forest Land Amreli
7Certificate of DCF about Over Lapping
8Certificate of User Agency and DCF regarding Court Case Amreli
9Certificate of User Agency of use of Fly Ash Amreli
10Cross Section Map
11Detail Note on the Project
12Justification Amreli
13Layout Plan of the Project Site Amreli
14Part-1 Amreli
15Site Inspection Report of the Forest Area by DFO Amreli
16Tree Enumeration List Provide by DFO Amreli
17Treffic Data of Last Five Years Amreli
18Undertaking by User Agency to Abide by any additional Condition Stipulated Amreli
19Undertaking for CA Amreli
20Undertaking for Environment Clearance Amreli
21Undertaking for FRA Amreli
22Undertaking for NPV Amreli
23Annexure XVIII by DFO Amreli
24Annexure XIX Amreli
25Annexure XX Amreli
26Annexure XXI Amreli
27Annexure XXII Amreli
28Annexure XXIII Amreli
29Annexure XXIV Amreli
30Annexure XXV Amreli
31Annexure XXXVIII Amreli
32Annexure XIX Bhavnagar
33Annexure XVI Bhavnagar
34Annexure XVII Bhavnagar
35Annexure XVIII Bhavnagar
36Annexure XX Bhavnagar
37Annexure XXI Bhavnagar
38Annexure XXII Bhavnagar
39Annexure XXIV Bhavnagar
40Annexure XXV Bhavnagar
41Annexure XXXVIII Bhavnagar
42Area Calculation Sheet Bhavnagar
43Certificate of DCF about Over Lapping Bhavnagar
44Certificate of Minimum use of forest Land Bhavnagar
45Certificate of User Agency and DCF of Court Case Bhavnagar
46Certificate of User Agency for Use of Fly Ash Bhavnagar
47Cross Section Map Bhavnagar
48Detail Note on the Project Bhavnagar
49Gazette Notification of the forest area Concern DFO Bhavnagar
50Justification Bhavnagar
51Layout Plan of Project Site Approval Bhavnagar
52Part-1 Bhavnagar
53Statement showing the detail of Non Forest Area Bhavnagar
54Traffic Data for Last Five Years Bhavnagar
55Undertaking by User Agency to Abide by any additional Condition Stipulated Bhavnagar Bhavnagar
56Undertaking for Environment & CRZ Clearance Bhavnagar
57Undertaking for FRA Settlement Bhavnagar
58Undertaking for NPV Bhavnagar
59Undertaking for Violation in Forest Bhavnagar
60Undertaking of CA Bhavnagar