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/HR/ROAD/151373/2022   (ii). Name of Project for which Forest Land is required : Development of 4/6 lane green field highway starts from Jalbehra (km 00.000) near Ismailabad to Patti Kankra (km 22.850) near Shahbad in the State of Haryana und   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 7.663 Ha. Forest Land Development of 4/6 lane green field highway starts from Jalbehra (km 00.000) near Ismailabad to Patti Kankra (km 22.850) near Shahbad in the State of Haryana under Bharatmala Pariyojana (Lot 6/ Package 6).   (iv). State : Haryana   (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) : 96100   (viii). Area of forest land proposed for diversion(in ha.): 7.663   (ix). Non-forest land required for this project(in ha.): 134.442   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : National Highways Authority of India   (ii). Address1 : House Number - 1397p, HUDA Sector - 13, Bhiwani   (iii). Address2 : NIL   (iv). State : Haryana   (v). District : Bhiwani   (vi). Pin : 127021   (vii). Landmark : NIL   (viii). Email address : piubhiwani@nhai.org   (ix). Landline Telephone No. : 1664-256100   (x). Fax No. : 1664-   (xi). Mobile No. : 7860399993   (xii). Website (if any) : www.nhai.org   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: Krishna   (ii). Middle Name: Murari   (iii). Last Name: Sharma   (iv). Gender: Male   (v). Designation: PD   (vi). Address 1: House Number 1397p, HUDA Sector-13, Bhiwani   (vii). Address 2: NIL   (viii). State: Haryana   (ix). District: Bhiwani   (x). Tehsil: Bhiwani   (xi). Pin: 127021   (xii). Landmark: NIL   (xiii). Email Address: piubhiwani@nhai.org   (xiv). Landline Telephone No.: 1664-256100   (xv). Fax No.: NIL   (xvi). Mobile No.: 7860399993   (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
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
1InprincipleFP/HR/ROAD/35922/20189-HRC117-2019-CHA58.5458.5407 Feb 2020
Total 58.54 58.54
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.Kurukshetra7.663134.442
Total7.663134.442
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Kurukshetra7.663134.442
Total7.663134.442
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Ismailabad2.64.146
2Jal Behra018.631
3Thaska Miranji013.472
4Duniya Majra01.075
5Rohti04.939
6Jhansa0.848123.125
7Tangaur0.07928.589
8Jharauli Khurd07.98
9Fatehgarh Jharauli06.916
10Kalsana0.04026.165
11Mamu Majra04.343
12Kalsani0.1123.61
13Gumti02.012
14Shahjadpur0.25211.816
15Jainpur2.451515.534
16Patti kankara1.282.089
Total 7.663 134.442
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road Construction7.663134.442
Total 7.663 134.442
C. Maps of forest land proposed to be diverted
Division 1. : Kurukshetra
  (i). Area of forest land proposed to be diverted(in ha.) : 7.663   (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).
1.7.663    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: NIL
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 800   (iii). Temporary Employment(Number of person-days): 450000
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?: No
H. Status of Environmental Clearance
  (i). Whether the Project requires Clearance under the Environment (Protection) Act 1986 ? : Yes   (a). Status of the Environmental Clearance to the Project: EC under process   (ii). Environmental Clearance File No.: 10/57/2021-IA.III
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?: Not Applicable   (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) . Reason for not providing Non-Forest Land: Not Applicable
Additional information Details
Documents
S.No Documents
Remarks
1Area Calculation Sheet
2Detail Note on Project
3Justification of project site location
4Project Sanction Letter
5Undertaking Certificate for No Muck Generation and Diposal
6Certificate For Minmum use of Forest Land
7Undertaking For No Other Alternative of Alignment and Diversion of Barest Minimum Forest Land
8Undertaking for No Wildlife Area
9Undertaking for Non-starting of any activity without sanction from Competent Authority
10Undertaking For Payment of NPV of Forest Area
11Undertaking for payment of cost of Compensatory Afforestation
12For Payment of Additional NPV of Forest Area
13Undertaking for FRA Certificate
14Compliance letter dt. 15.3.2022
15Administrative Approval
16NHAI letter reg. FRA
17Layout Plan of the proposed diverted area showing patch wise area Calculation
18Minutes of the Expert Appraisal Committee (Infra-I) for EC
19NOC of Railway
20Detail Report (EIA)
21Compliance Letter dated 14 Feb 2023