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/144763/2021   (ii). Name of Project for which Forest Land is required : Improvements of road from kalakeri village to hunashikumari villagei in Dharwad taluka of Dharwad District   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 0.9850 Ha. of Forest land for Improvement of Road from Kalakeri village to hunashikumari village, Dharwad Taluk, Dharwad District in favour of Executive Engineer, PWD Dharwad.   (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) : 460   (viii). Area of forest land proposed for diversion(in ha.): 0.985   (ix). Non-forest land required for this project(in ha.): 1.1505   (x). Total period for which the forest land is proposed to be diverted(in years): 50
A-2. Details of User Agency
  (i). Name : EXECUTIVE ENGINEER PUBLIC WORKS DEPARTMENT DIVISION DHARWAD   (ii). Address1 : Opposite All India Radio Dharwad   (iii). Address2 : Opposite All India Radio   (iv). State : Karnataka   (v). District : Dharwad   (vi). Pin : 580008   (vii). Landmark : Opposite All India Radio   (viii). Email address : pwddhaexecutiveengineer@gmail.com   (ix). Landline Telephone No. : 836-2747749   (x). Fax No. : 836-2747944   (xi). Mobile No. : 9448418938   (xii). Website (if any) : No   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Somappa   (ii). Middle Name: B   (iii). Last Name: Choudannavar   (iv). Gender: Male   (v). Designation: Executive Engineer PWD IWTD DIVISION Dharwad DHARWAD   (vi). Address 1: Opposite All India Radio Dharwad   (vii). Address 2: Opposite All India Radio Dharwad   (viii). State: Karnataka   (ix). District: Dharwad   (x). Tehsil: Dharwad   (xi). Pin: 580008   (xii). Landmark: Opposite All India Radio Dharwad   (xiii). Email Address: pwddhaexecutiveengineer@gmail.com   (xiv). Landline Telephone No.: 836-2747749   (xv). Fax No.: 08362747944   (xvi). Mobile No.: 9448418938   (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.Dharwad0.9851.1505
Total0.9851.1505
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Dharwad0.9851.1505
Total0.9851.1505
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1KALAKERI_FOREST_SY_NO_2140.08850
2KALAKERI_FOREST_SY_NO_122 PART0.17520
3KALAKERI_FOREST_SY_NO_1390.00930
4KALAKERI_FOREST_SY_NO_1220.24760
5KALAKERI_FOREST_SY_NO_3900.12020
6KALAKERI_FOREST_SY_NO_3910.09250
7KALAKERI_FOREST_SY_NO_4080.04760
8KALAKERI_FOREST_SY_NO_3870.01790
9KALAKERI_FOREST_SY_NO_3820.06860
10KALAKERI_FOREST_SY_NO_1140.11760
11EXISTING ROAD GRAMTHANA00.0324
12EXISTING ROAD 100.0599
13EXISTING ROAD 200.0874
14EXISTING ROAD 300.0176
15EXISTING ROAD 400.1962
16EXISTING ROAD 500.0099
17EXISTING ROAD 600.336
18EXISTING ROAD 700.2934
19EXISTING ROAD 800.0341
20EXISTING ROAD S Y NO 20800.0341
21EXISTING ROAD S Y NO 36900.0341
Total 0.985 1.1351
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1CARRIAGE WIDTH0.70140.8239
2SHOULDER0.28340.3266
Total 0.9848 1.1505
C. Maps of forest land proposed to be diverted
Division 1. : Dharwad
  (i). Area of forest land proposed to be diverted(in ha.) : 0.985   (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).
1.0.985    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: Not possible to provide alternative alignment.
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? : 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
1GPS_FOREST_CO-ORDINATES
2GPS_FOREST_STONES_CO-ORDINATES
3KALAKERI_Forest_ROAD_CROSS_SECTIONS
4PWD_KALAKERI_FOREST_RTC
5PWD_DHARWAD_AGREEING_NPV_CA_LETTER
6PWD_DHARWAD_NAME_JUSTIFICATION_LETTER
7PWD_STONE_FIXING_LETTER
8WORK AGREEMENT
9PWD_Administratival Approval
10VILLAGE MAP _ COMPLIANED
11TOPO MAP _ COMPLIANED
12AREA STSTMENT _ COMPLIANED
13EXISTING ROAD AREA COORDINATES _ COMPLIANED