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/WATER/37837/2018   (ii). Name of Project for which Forest Land is required : Designing, Construction, Testing & Commissioning of Intake Well cum Pump House, Water Treatment Plant, Clear water reservoir cum Pump House, Providing, Lowering Testing and Commissioning of Rising Main and Transmission Mains, Surge Control Devices on Pipelines, Civil, Electromechanical Works and Instrumentation Works including all allied works comp   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Water transmission line network from Sindhrot intake well to Kalali junction via Raipura crossing-Bhaili (Km. 0/00 to 13/050), Bhimpura cross road junction Aarana lawns(Km. 0/00 to 2/575)   (iv). State : Gujarat   (v). Category of the Proposal : Drinking Water   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 165758605600   (viii). Area of forest land proposed for diversion(in ha.): 3.4134   (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): 00
A-2. Details of User Agency
  (i). Name : VADODARA MUNICIPAL CORPORATION   (ii). Address1 : Khanderao Market Building, Rajmahal Road   (iii). Address2 : Vadodara   (iv). State : Gujarat   (v). District : Vadodara   (vi). Pin : 390209   (vii). Landmark : Khanderao Market   (viii). Email address : exen.vmc@gmail.com   (ix). Landline Telephone No. : 265-2433118   (x). Fax No. : 265-   (xi). Mobile No. : 9879000704   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Rajesh   (ii). Middle Name: R   (iii). Last Name: Chauhan   (iv). Gender: Male   (v). Designation: ExecutiveEngineer   (vi). Address 1: 20, Rajeshwari Society   (vii). Address 2: R.V.Desai Road   (viii). State: Gujarat   (ix). District: Vadodara   (x). Tehsil: Vadodara   (xi). Pin: 390001   (xii). Landmark: Rajeshwari Society   (xiii). Email Address: exen.vmc@gmail.com   (xiv). Landline Telephone No.: 265-2433118   (xv). Fax No.: NIL   (xvi). Mobile No.: 9879000704   (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.Vadodara SF3.41340
Total3.41340
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Vadodara3.41340
Total3.41340
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Kotna0.11730
2Sindhrot1.00740
3Ampad0.64860
4Raypura0.36570
5Bhayli10.70380
6Bhayli20.1380
7Sindhrot20.040320
8Sherkhi0.392280
Total 3.4134 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Kotna0.11730
2Sindhrot1.00740
3Ampad0.64860
4Raypura0.36570
5Bhayali10.70380
6Bhayali20.1380
7Sindhrot20.040320
8Sherkhi0.392280
Total 3.4134 0
C. Maps of forest land proposed to be diverted
Division 1. : Vadodara SF
  (i). Area of forest land proposed to be diverted(in ha.) : 3.4134   (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).
1.3.4134    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: na
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 9000   (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 ?: Not Applicable   (iii). No. of districts involved for raising Compensatory Afforestation: 1   (iv). No. of patches: One
District 1. : Vadodara
  (a). Village: Rayan Talavdi   (b). Area(in ha.): 3.4134   (c). Copy of KML file of the patch:     View File   (d). Khasra details: s.no.246   (e). Present owner: User Agency   (f). Copy of Ownership proof:
  (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
1cost benifit certificate
2FRA certificate attached here
3georeference map (not able to attched on above position)
4toposheet (not able to attched on above position)
5land ownership detail (not able to attached on above position)
6land acquired total station map (not able to attached on above position)
7scheme of compensatory afforestation
8certificate of compensatory afforestation