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/156224/2022   (ii). Name of Project for which Forest Land is required : Diversion of 25.763 Ha of forest land in Hosanagara (T), Shimoga (D) for Construction of 2 L-PS road from Km 55.6-Adagodi to Km 90.7-Mavinakoppa of NH766C with 4 major bridges across Sharavathi Backwaters   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 25.763 Ha of forest land in Hosanagara (T), Shimoga (D) for Construction of 2 Lane with Paved Shoulder road from Km 55.6-Adagodi to Km 90.7-Mavinakoppa of NH766C with 4 major bridges across Sharavathi Backwaters in Favour of EE, NH Division, Shimoga.   (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) : 22875   (viii). Area of forest land proposed for diversion(in ha.): 25.763   (ix). Non-forest land required for this project(in ha.): 22.624   (x). Total period for which the forest land is proposed to be diverted(in years): 30
A-2. Details of User Agency
  (i). Name : EXECUTIVE ENGINEER, NH DIVISION, SHIMOGA   (ii). Address1 : Executive Engineer, NH Division, APMC Yard, Shimoga   (iii). Address2 : NIL   (iv). State : Karnataka   (v). District : Shimoga   (vi). Pin : 577204   (vii). Landmark : NIL   (viii). Email address : cenh@kpwd.gov.in   (ix). Landline Telephone No. : 0--   (x). Fax No. : 0-   (xi). Mobile No. : 9448425301   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Peer   (ii). Middle Name: NIL   (iii). Last Name: Pasha   (iv). Gender: NIL   (v). Designation: Incharge Officer   (vi). Address 1: Executive Engineer, NH Division, APMC Yard, Shimoga   (vii). Address 2: NIL   (viii). State: Karnataka   (ix). District: Shimoga   (x). Tehsil: NIL   (xi). Pin: 577204   (xii). Landmark: NIL   (xiii). Email Address: peerpasha1961@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 9845057311   (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.Sagar25.76322.624
Total25.76322.624
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Shivamogga25.76322.624
Total25.76322.624
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Mavinakoppa SN 1500.03
2Mavinakoppa Road00.164
3Ganganakoppa SN 210.3370
4Ganganakoppa SN 50.430
5Ganganakoppa SN 1900.638
6Ganganakoppa SN 2000.327
7Ganganakoppa SN 800.25
8Ganganakoppa SN 700.287
9Ganganakoppa SN 600.001
10Ganganakoppa SN 300.37
11Ganganakoppa SN 200.389
12Ganganakoppa SN 7400.569
13Ganganakoppa SN 8100.113
14Ganganakoppa SN 6900.06
15Ganganakoppa SN 6800.281
16Ganganakoppa SN 6700.134
17Ganganakoppa SN 6600.089
18Ganganakoppa SN 6500.111
19Ganganakoppa SN 6400.525
20Ganganakoppa SN 5500.312
21Ganganakoppa Road00.315
22Ganganakoppa SN 5200.587
23Kaluru SN 1360.0620.062
24Kaluru SN 13800.31
25Kaluru SN 13700.055
26Kaluru SN 13500.015
27Kaluru SN 14200.076
28Kaluru Village00.39
29Kaluru Nala00.274
30Sutta SN 750.1650.165
31Sutta SN 620.810
32Sutta SN 101.6350
33Sutta SN 6600.251
34Sutta SN 6500.194
35Sutta SN 11700.732
36Sutta Nala00.518
37Manasette SN 381.8610
38Guddenakoppa SN 272.070
39Guddenakoppa SN 450.2220
40Guddenakoppa SN 461.260
41Guddenakoppa SN 8900.855
42Guddenakoppa SN 8500.28
43Guddenakoppa Nala00.201
44Guddenakoppa SN 500.195
45Guddenakoppa SN 600.573
46Guddenakoppa SN 2301.145
47Hebburali SN 2043.1410
48Hebburali SN 2213.6120
49Hebburali SN 513.2890
50Hebburali SN 441.5170
51Hebburali Nala00.167
52Hebburali SN 10700.142
53Hebburali SN 8000.649
54Hebburali SN 7900.406
55Hebburali SN 4500.001
56Hebburali SN 4600.296
57Hebburali SN 4800.443
58Hebburali SN 4200.002
59Hosuru SN 430.530
60Adagodi SN 741.9920
61Adagodi SN 791.740
62Adagodi SN 7500.114
63Tenkabylu SN 1300.769
64Tenkabylu SN 1500.092
65Ganganakoppa Sy No 130.2840
66Kaluru Sy No 1330.8060
Total 25.763 14.924
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1CARRIAGE WAY6.6694.378
2PAVED SHOULDER2.5571.825
3EARTHERN SHOULDER1.6681.25
4DRAIN AND SLOPE14.8699.314
Total 25.763 16.767
C. Maps of forest land proposed to be diverted
Division 1. : Sagar
  (i). Area of forest land proposed to be diverted(in ha.) : 25.763   (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).
1.25.763    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): 250   (iii). Temporary Employment(Number of person-days): 5000
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: One
District 1. : Shimoga
  (a). Village: Kannuru   (b). Area(in ha.): 53   (c). Copy of KML file of the patch:     View File   (d). Khasra details: Dhanagalige Muphattu   (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
1Alignment Map
2Annual Plan Report
3Alignment power point presentation
4Alignment details with map
5Comparative Study with various Alignment
6Acknowledgement from DC Office Shimoga
7Acknowledgment from DCF
8The changes in area as per actuals and as reported by DCF has been made, tabulated and submitted in8 number of hard copies to DFO, same is also submitted online herewith. Letter is acknowledged by DC Shimoga and DFO Sagar
9NO Objection certificate of KPCL
10Forest GPS Co-ordinates Bekkodi
11Component wise GPS Co-ordinates Bekkodi
12Component Wise Area Details Bekkodi
13CA Land Kannuru Topo Map
14CA Land Kannuru Village Map
15CA Land Kannuru GPS Co-ordinates
16CA Undertaking Form Bekkodi
17FRA Undertaking Form Bekkodi
18Justification for Location of the Project Bekkodi
19NOC for CA Land Bekkodi
20NPV Undertaking Form Bekkodi
21Stone Pillar Undertaking Form Bekkodi
22Bekkodi Georeferenced Map
23Bekkodi Topo Map
24Individual Village Map Bekkodi
25Village Map Bekkodi
26Bekkodi Forest Area Statement
27Bekkodi Non-Forest Area Statement
28Bekkodi Forest Area Statement
29Bekkodi Area Statement Cadastral
30Bekkodi Wildlife Mitigation Plan