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/KA/Pipeline/44313/2020   (ii). Name of Project for which Forest Land is required : Bharmasagara LIS, Construction of rising main pipe line (CH : 36.225 to CH - 37.550 Km) parellel to NH-48 in Anagodu village, Davanagere Taluk & District   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Survey, Investigation, design, Supply, Installation, Testing and Commissioning of Lift Irrigation system (Head Works consisting of Intake canal, Jack well cum pump house, Power supply including substations and Transmission lines, Rising Main and Delivery chamberetc) and Construction of Gravity   (iv). State : Karnataka   (v). Category of the Proposal : Pipeline   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 56500   (viii). Area of forest land proposed for diversion(in ha.): 0.789   (ix). Non-forest land required for this project(in ha.): 111.611   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : EXECUTIVE ENGINEER KNNL DAVANAGERE   (ii). Address1 : O/O EXECUTIVE ENGINEER, NO-05, BHADRA CANAL DIVISION,   (iii). Address2 : HADADI ROAD, DAVANGERE   (iv). State : Karnataka   (v). District : Davanagere   (vi). Pin : 577005   (vii). Landmark : RURAL POLICE STATION   (viii). Email address : sumahs1989@gmail.com   (ix). Landline Telephone No. : 8192-264669   (x). Fax No. : 8192-   (xi). Mobile No. : 9986512638   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Chandrashekarayya   (ii). Middle Name: NIL   (iii). Last Name: A   (iv). Gender: Male   (v). Designation: Assistant Executive Engineer   (vi). Address 1: O/O ASSISTANT EXECUTIVE ENGINEER, NO-02 BHADRA CANAL DIVISION, DAVANGERE   (vii). Address 2: NIL   (viii). State: Karnataka   (ix). District: Davanagere   (x). Tehsil: Davanagere   (xi). Pin: 577005   (xii). Landmark: RURAL POLICE STATION   (xiii). Email Address: ram.ssnc@gmail.com   (xiv). Landline Telephone No.: 8192-264669   (xv). Fax No.: NIL   (xvi). Mobile No.: 9448288828   (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.Davanagere0.78928.966
2.Chitradurga082.359
Total0.789111.325
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Davanagere0.78928.966
1.Chitradurga082.359
Total0.789111.325
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Halsabalu01.582
2Haraganahalli00.78
3Hanagavadi02.445
4Agasanakatte01.665
5Halebathi02.37
6Kundavada02.43
7Shamanuru00.69
8Shiramagondanahalli00.69
9Avaragere02.595
10Vadenahalli00.555
11Kalapanahalli01.005
12Honnuru00.57
13Mallashettyhalli01.08
14Haleuru / Kogganuru01.335
15Anagodu0.7893.804
16Haluvarthi00.54
17Hebbalu02.13
18Panjenahalli00.465
19Hunasikatte01.5
20Lakkamuthenahalli00.735
21Emmehatti02.175
22Bevinahalli00.276
23Adavigaollarahalli00.299
24Ajjappanahalli02.674
25Alagatti00.246
26Alagavadi02.459
27Arasuru00.948
28Bahadurgatta00.476
29Ballekatte (Katralu)00.018
30Bedara Shivanakere00.458
31Bedara Bommenahalli00.009
32Beelangi01.986
33Bevinahalli - Bharamasagara00.72
34Bharamasagara06.238
35Bommrnahalli00.536
36Chikkabbigere01.103
37Chikkabennuru00.488
38Chikkapura00.433
39Chikkenahalli00.882
40D Madakaripura00.226
41Doddiganahalu02.26
42Dyamavvanahalli01.153
43Gollarahalli02.684
44Gurappanahalli01.336
45Halavudara03.797
46Hale Rangapura01.016
47Hampanuru02.747
48Heggadehalu01.243
49Heggare01.904
50Hemmanagatta01.679
51Hulageri00.209
52Issamudra05.595
53J.I. Kasavanahalli00.675
54Jammenahalli01.352
55Jattalahalli00.169
56Kalagere00.087
57Kadlegudda04.194
58Kodagahalli00.582
59Kodi Rangavvanahalli01.487
60Kogunde00.937
61Kolahalu00.778
62Konanuru01.788
63Kyaspura00.669
64Lakshmisagara00.962
65Lingavva Nagathihalli01.207
66Marijogihalli00.202
67Megalahalli00.766
68Nandihalli01.847
69Nellikatte01.929
70Obalapora01.417
71Palakihalli02.635
72Pamarahalli01.202
73Sadarahalli02.686
74Shiddapura00.214
75Shigehalli00.312
76Sirigere00.967
77Vaddara Siddavanahalli01.999
78Veeravva Nagathihalli00.712
79Yalagodu02.31
Total 0.789 111.324
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Jack well / Pump House00.18
2Electrical Sub-Station00.08
3Service Road / Approach Road00.032
4Intake Canal00.285
5Raising Main0.78934.044
6Gravity Main076.9878
Total 0.789 111.6088
C. Maps of forest land proposed to be diverted
Division 1. : Davanagere
  (i). Area of forest land proposed to be diverted(in ha.) : 0.789   (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).
1.0.789    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: Yes   (a). Copy of map indicating location of alternative examined:
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?: No
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?: 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
1Typical cross section of the pipe laying
2Pipe line alignment superimposed over all village maps
3Consolidated undertaking letter
4Detailed Project Report (DPR)
5Acknowledgment copy for the submission of 9 sets of hard copy of the forest application to DCF, Chitradurga
6Alternative alignment to avoid deemed forest area in Chitradurga Division.