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/ROAD/140781/2021
(ii). Name of Project for which Forest Land is required :
Diversion of 2.4346 ha of forest land for improvement of existing Road from Pathapalya to Polanayakanapalli via Singappagarapalli, Kamasanapalli, Gummallapalli Villages (CH: 3.219km to 4.285KM and Ch: 7.2KM to 8.929 Km) Mittemari & Pathapalya [H], Bagepalli [T], Chikkaballapura [D] in favour of the Executive Engineer, Project Division (PMGSY),Chic
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
Diversion of 2.4346 ha of forest land for improvement of existing Road from Pathapalya to Polanayakanapalli via Singappagarapalli, Kamasanapalli, Gummallapalli Villages (CH: 3.219km to 4.285KM and Ch: 7.2KM to 8.929 Km) Mittemari & Pathapalya [H], Bagepalli [T], Chikkaballapura [D] in favour of the
(iv). State :
Karnataka
(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) :
1120
(viii). Area of forest land proposed for diversion(in ha.):
2.4346
(ix). Non-forest land required for this project(in ha.):
11.9871
(x). Total period for which the forest land is proposed to be diverted(in years):
50
A-2.
Details of User Agency
(i). Name :
EE PMGSY CHIKKABALLAPURA (KRRDA)
(ii). Address1 :
Venugopalaswamy temple road, Behind New middle School
(iii). Address2 :
NIL
(iv). State :
Karnataka
(v). District :
Chikkaballapura
(vi). Pin :
562101
(vii). Landmark :
NIL
(viii). Email address :
pmgsycbp@gmail.com
(ix). Landline Telephone No. :
0-
(x). Fax No. :
0-
(xi). Mobile No. :
9448407946
(xii). Website (if any) :
online.omms.nic.in
(xiii). Legal status of User Agency :
State Government
A-3.
Details of Person Making Application
(i). First Name:
Nagaraja
(ii). Middle Name:
Lingapura
(iii). Last Name:
Kempegowda
(iv). Gender:
Male
(v). Designation:
Executive Engineer
(vi). Address 1:
#441, IDSMT Layout, APMC back door, chikkballapur-562101
(vii). Address 2:
NIL
(viii). State:
Karnataka
(ix). District:
Chikkaballapura
(x). Tehsil:
NIL
(xi). Pin:
562101
(xii). Landmark:
NIL
(xiii). Email Address:
pmgsycbp@gmail.com
(xiv). Landline Telephone No.:
0-
(xv). Fax No.:
NIL
(xvi). Mobile No.:
9448084264
(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
1
Returned
FP/KA/ROAD/140781/2021
KFD/HoFF/A5-4(GFL)/8/2021-FC, E-487813
0.9945
0
Total
0.9945
0
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.
Chikkaballapura
2.4346
11.9871
Total
2.4346
11.9871
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Chikkaballapura
2.4346
11.9871
Total
2.4346
11.9871
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
Forest Sy No 51 of Singappagarapalli Village
0.2885
0
2
Forest Sy No 26 Kamasanapalli Village
0.0189
0
3
Forest Sy No 51 of Singappagarapalli Village
0.3487
0
4
Forest Sy No 23 of Gummallapalli Village
0.3052
0
5
Forest Sy. No 51 of Singappagarapalli Village
0.0769
0
6
Forest Sy No 26 Kamasanapalli Village
0.0048
0
7
.Forest Sy No 51 of Singappagarapalli Village
0.0934
0
8
.Forest Sy No 23 of Gummallapalli Village
0.0815
0
9
Forest Sy No51 of Singappagarapalli Village
0.077
0
10
.Forest Sy No 26 Kamasanapalli Village
0.0056
0
11
Forest Sy.No 51 of Singappagarapalli Village
0.0921
0
12
Forest Sy No 23. of Gummallapalli Village
0.081
0
13
Forest Sy No 51 -of Singappagarapalli Village
0.1734
0
14
-Forest Sy No 23 of Gummallapalli Village
0.1523
0
15
Sy No 51 of Singappagarapalli Village
0.1442
0
16
Sy No 26 Kamasanapalli Village
0.0091
0
17
Forest Sy No 51 of Singappagarapalli Village
0.1748
0
18
Forest Sy No.23 of Gummallapalli Village
0.1527
0
19
Forest-Sy No.51 of Singappagarapalli Village
0.1443
0
20
Forest- Sy No. 26 Kamasanapalli Village
0.0102
0
21
Kamasanahalli Sy No. 87
0
0.0456
22
Kamasanahalli Sy No.1
0
0.1634
23
Kamasanahalli Sy No. (V)
0
0.13015
24
Kamasanahalli Sy No.85
0
0.0171
25
Kamasanahalli Sy No.66
0
0.12445
26
Kamasanahalli Sy No.65
0
0.0589
27
Kamasanahalli Sy No.63
0
0.17195
28
Kamasanahalli Sy No.62
0
0.1843
29
Kamasanahalli Sy No.45
0
0.361
30
Kamasanahalli Sy No.61
0
0.0798
31
Kamasanahalli Sy No.60
0
0.16245
32
Kamasanahalli Sy No.59
0
0.1596
33
Kamasanahalli Sy No.58
0
0.32775
34
Kamasanahalli Sy No.50
0
0.2622
35
Kamasanahalli Sy No.46
0
0.08835
36
Kamasanahalli Sy No.33
0
0.0513
37
Kamasanahalli Sy No.34
0
0.10355
38
Kamasanahalli Sy No.36
0
0.0912
39
Kamasanahalli Sy No.39
0
0.06365
40
Kamasanahalli Sy No.41
0
0.0608
41
Kamasanahalli Sy No.40
0
0.01425
42
Kamasanahalli Sy No.42
0
0.1064
43
Kamasanahalli Sy No. 41
0
0.1121
44
Singappagarapalli Sy No.53
0
0.69635
45
Singappagarapalli Sy No.55
0
0.09785
46
Singappagarapalli Sy No. (V)
0
0.0703
47
Singappagarapalli Sy No.26
0
0.22515
48
Singappagarapalli Sy No.31
0
0.0703
49
Singappagarapalli Sy No.30
0
0.12445
50
Singappagarapalli Sy No.29
0
0.0646
51
Singappagarapalli Sy No.28
0
0.03515
52
Singappagarapalli Sy No.52
0
0.798
53
Singappagarapalli Sy No. 53
0
0.1539
54
Gummalapalli Sy No.22
0
0.84835
55
Gummalapalli Sy No.19
0
0.1007
56
Gummalapalli Sy No.76
0
0.1216
57
Gummalapalli Sy No.75
0
0.3496
58
Gummalapalli Sy No.29
0
0.02375
59
Gummalapalli Sy No.70
0
0.07125
60
Gummalapalli Sy No.71
0
0.0513
61
Gummalapalli Sy No. (V)
0
0.1786
62
Gummalapalli Sy No.68
0
0.06745
63
Gummalapalli Sy No.67
0
0.0399
64
Gummalapalli Sy No.69
0
0.15295
65
Gummalapalli Sy No.38
0
0.1672
66
Gummalapalli Sy No.64
0
0.03135
67
Gummalapalli Sy No.55
0
0.24985
68
Dugginayakanapalli Sy No.24
0
0.35815
69
Dugginayakanapalli Sy No.19
0
0.33535
70
Dugginayakanapalli Sy No.75
0
0.1026
71
Dugginayakanapalli Sy No.73
0
0.04275
72
Dugginayakanapalli Sy No.71
0
0.0247
73
Dugginayakanapalli Sy No.70
0
0.076
74
Dugginayakanapalli Sy No.63
0
0.3211
75
Dugginayakanapalli Sy No.56
0
0.0323
76
Dugginayakanapalli Sy No.62
0
0.02185
77
Dugginayakanapalli Sy No. 56
0
0.08455
78
Poolakuntlapalli Sy No.36
0
0.1273
79
Poolakuntlapalli Sy No.38
0
0.21185
80
Poolakuntlapalli Sy No.41
0
0.0589
81
Polinayakanapalli Sy No.225
0
0.05415
82
Polinayakanapalli Sy No.224
0
0.1102
83
Poolikakuntlapalli Sy No.46
0
0.3439
84
Polinayakanapalli Sy No.223
0
0.0627
85
Polinayakanapalli Sy No.218
0
0.0494
86
Polinayakanapalli Sy No.215
0
0.0095
87
Polinayakanapalli Sy No.216
0
0.02185
88
Poolikakuntlapalli Sy No. 52
0
0.0266
89
Poolikakuntlapalli Sy No. 53
0
0.0665
90
Poolikakuntlapalli Sy No. 54
0
0.04465
91
Poolikakuntlapalli Sy No. 45
0
0.07695
92
Poolikakuntlapalli Sy No. (V)
0
0.09595
93
Poolikakuntlapalli Sy No. 62
0
0.37145
94
Polinayakanapalli Sy No.159
0
0.0304
95
Polinayakanapalli Sy No.160
0
0.03515
96
Polinayakanapalli Sy No.114
0
0.0665
97
Polinayakanapalli Sy No.161
0
0.1862
98
Polinayakanapalli Sy No.112
0
0.04275
99
Patapalya Sy No. 2
0
0.08645
100
Patapalya Sy No. 190
0
0.02185
101
Patapalya Sy No. 189
0
0.08645
102
Patapalya Sy No. 172
0
0.25935
103
Patapalya Sy No. 171
0
0.08455
104
Patapalya Sy No. 152
0
0.10925
105
Patapalya Sy No. 146
0
0.08645
106
Patapalya Sy No. 153
0
0.0304
Total
2.4346
11.9871
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Forest Drain LHS
0.2567
0
2
Forest Drain RHS
0.2558
0
3
Forest Shoulder LHS
0.4811
0
4
Forest Shoulder RHS
0.48
0
5
Shoulder Both Side - Non Forest Land
0
4.7318
6
Carrage Way -Non Forest Land
0
4.7318
7
Drains- Non Forest Land
0
2.5235
8
Forest Carriage Way
0.961
0
Total
2.4346
11.9871
C.
Maps of forest land proposed to be diverted
Division 1. : Chikkaballapura
(i). Area of forest land proposed to be diverted(in ha.) :
2.4346
(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.
2.4346
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 ?:
Yes
(ii). Permanent/Regular Employment(Number of persons):
5
(iii). Temporary Employment(Number of person-days):
200
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? :
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 ?:
No
(iii). No. of districts involved for raising Compensatory Afforestation:
1
(iv). No. of patches:
Two
District 1. : Chikkaballapura
(a). Village:
Singappagarapalli
(b). Area(in ha.):
1.7524
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
Sy No.53
(e). Present owner:
Others
(f). Copy of ownership proof:
(g). Copy of Mou/agreement executed between the Present owner and the User Agency:
(h). Copy of non encumberence certificate for the forest land:
District 2. : Chikkaballapura
(a). Village:
Devala varapalli
(b). Area(in ha.):
0.6822
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
Sy No.62
(e). Present owner:
Others
(f). Copy of ownership proof:
(g). Copy of Mou/agreement executed between the Present owner and the User Agency:
(h). Copy of non encumberence certificate for the forest land:
(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
1
Tender Approved Copy of Project
2
Boundary stone letter
3
Cross section of road
4
Guard stone temporary
5
Nodal officer
6
Admin Approval of Project
7
Justification and along with Alternative Alignment Map
8
Proposed Forest Land - RTC Copy
9
Proposed CA Land - RTC Copy and Tahasildar Order Copies
10
Entire Alignment with Survey Number and Village Wise Forest and Non Forest Land details
11
GPS Co Ordinates
12
Undertaking for payment of CA and NPV
13
Undertaking for payment of NPV
14
Village Wise and Survey Number and area wise breakup details
15
Component Wise Breakup Forest and Non Forest details
16
Assistant Commissioner, Revenue Dept letter
17
CA Suitability Certificate
18
Entire Alignment RevisedMap
19
Plain Map With Zoom View Revised Map
20
Detailed Project Report- DPR
21
Proposed CA - Plain Map and Google Maps
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