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/45072/2020   (ii). Name of Project for which Forest Land is required : Widening of NH-58 from Khokhra Border to Mathasur (km. 00/000 to km. 56/620) (Protected Forest)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of Forest Land For Non Forest Purpose for Widening Of Single Lane To Two Lane KhokhraGujarat Border–Vijaynagar-Antarsuba-Mathasur Road On NH-58 (Protected Forest)   (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) : 35754   (viii). Area of forest land proposed for diversion(in ha.): 39.547   (ix). Non-forest land required for this project(in ha.): 89.793   (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 NH AHMEDABAD   (ii). Address1 : Executive Engineer, Multistory, C Block, 2 nd floor, Vastrapur, Ahmedabad   (iii). Address2 : NIL   (iv). State : Gujarat   (v). District : Ahmedabad   (vi). Pin : 380052   (vii). Landmark : Himalya Mall   (viii). Email address : nh58fa@gmail.com   (ix). Landline Telephone No. : 79-260304   (x). Fax No. : 79-   (xi). Mobile No. : 9426590386   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: R   (ii). Middle Name: D   (iii). Last Name: Dhruv   (iv). Gender: Male   (v). Designation: MoRTH Deputy Executive Engineer NH SUB DIVISION IDAR   (vi). Address 1: OFFICE OF THE Dy. EXECUTIVE ENGINEER, NATIONAL HIGHWAY, SUB DIVISION, NEAR PANCHAYAT REST HOUSE   (vii). Address 2: TOWER ROAD IDAR   (viii). State: Gujarat   (ix). District: Sabar Kantha   (x). Tehsil: Idar   (xi). Pin: 383430   (xii). Landmark: PANCHAYAT REST HOUSE IDAR   (xiii). Email Address: nh58fa@gmail.com   (xiv). Landline Telephone No.: 79-260304   (xv). Fax No.: NIL   (xvi). Mobile No.: 9426590386   (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.Sabarkantha-North SF39.54789.793
Total39.54789.793
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Sabar Kantha39.54789.793
Total39.54789.793
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Khokhra04.47038541
2Kelava07.40569772
3Kanthariya02.94669856
4Sarsav03.4218226
5Chandvasa06.1173501
6Rajpur01.8797604
7Navagadh Umbariya00.8793012
8Tintaran02.6186463
9Vijaynagar00.170205
10Saroli2.89653731.26349831
11Vanaj03.69626569
12Kherwada00.56332445
13Golvada1.41648920.82842279
14Mondhri1.46127820.61879954
15Vajepur04.4048252
16Antarsumba03.8805698
17Bhambhudi00.2834277
18Androkha00.2667491
19Bhupatgadh0.65356010.43652505
20Kundala2.24860871.7543905
21Kathvavdi2.81567331.1831583
22Dholvani2.25296421.3874142
23Vireshwar1.67586950.7800029
24Kalvan3.60125931.6160956
25Choriwad8.02771961.6029765
26Chotasan1.29773510.4028935
27Kadiyadara3.53226563.8651418
28Jalodara4.0272571.4494401
29Panol2.460271.9799251
30Mathasur1.17926840.562099
Total 39.5467555 62.73581242
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
11 - Saroli - LHS1.57123639920
22 - Saroli - RHS1.325300900040
33 - Golvada - LHS0.198060201010
44 - Golvada - RHS0.2727182990
55 - Golvada - LHS0.42947350240
66 - Golvada - RHS0.5162371980
77 - Mondhri - LHS0.781974098620
88 - Mondhri - RHS0.679304097230
99 - Bhupatgadh - LHS0.299181201580
1010 - Bhupatgadh - RHS0.35437889740
1111 - Kundala - LHS0.89702779320
1212 - Kundala - RHS1.3515809040
1313 - Kathvavdi - LHS1.060901605020
1414 - Kathvavdi - RHS1.754771708070
1515 - Dholvani - LHS1.461640499830
1616 - Dholvani - RHS0.791323704830
1717 - Vireshwar - LHS0.871588099750
1818 - Vireshwar - RHS0.804281401550
1919 - Kalvan - LHS1.94409218750
2020 - Kalvan - RHS1.657167093750
2121 - Choriwad - LHS3.7172894990
2222 - Choriwad - RHS4.310430080
2323 - Chotasan - LHS0.50653240
2424 - Chotasan - RHS0.79120270360
2525 - Kadiyadara - LHS0.84449769180
2626 - Kadiyadara - RHS1.44354140090
2727 - Kadiyadara - LHS0.47628409740
2828 - Kadiyadara - RHS0.76794240
2929 - Jalodara - LHS1.886607104850
3030 - Jalodara - RHS2.140649899650
3131 - Panol - LHS1.149187407990
3232 - Panol - RHS1.311082598910
3333 - Mathasur - LHS0.5891734020
3434 - Mathasur - RHS0.5900950020
Total 39.54675548008 0
C. Maps of forest land proposed to be diverted
Division 1. : Sabarkantha-North SF
  (i). Area of forest land proposed to be diverted(in ha.) : 39.547   (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).
1.39.547    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: There is no other alternative alignment for this p
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: No
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: No Data
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 ?: 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
NIL