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/33965/2018   (ii). Name of Project for which Forest Land is required : Construction of widening to Two/Four lane with paved shoulders from km. 0.000 to km. 101.400 NH-50 in Bidar District   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Widening of Existing National Highway (NH-50)   (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) : 76440   (viii). Area of forest land proposed for diversion(in ha.): 40.79   (ix). Non-forest land required for this project(in ha.): 43.8623   (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 NATIONAL HIGHWAY DIVISION   (ii). Address1 : H No 11/1844 Back side SB College Vidyanagar,Kalaburagi   (iii). Address2 : NIL   (iv). State : Karnataka   (v). District : Gulbarga   (vi). Pin : 585103   (vii). Landmark : SB College, Vidyanagar. Kalaburagi   (viii). Email address : eenhdnklb@gmail.com   (ix). Landline Telephone No. : 8472-222783   (x). Fax No. : 8472-   (xi). Mobile No. : 9448038789   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Executive Engneer   (ii). Middle Name: NIL   (iii). Last Name: NH Division Kalaburgi   (iv). Gender: Male   (v). Designation: EE   (vi). Address 1: H No 11/1844 Back side SB College Vidyanagar, kalaburgi   (vii). Address 2: NIL   (viii). State: Karnataka   (ix). District: Gulbarga   (x). Tehsil: Gulbarga   (xi). Pin: 585103   (xii). Landmark: H No 11/1844 Back side SB College vidya nagar kala   (xiii). Email Address: chavanee0@gmail.com   (xiv). Landline Telephone No.: 8472-222783   (xv). Fax No.: 08472222783   (xvi). Mobile No.: 9945455503   (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.Bidar40.7943.8623
Total40.7943.8623
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bidar40.7943.8623
Total40.7943.8623
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Dhannur (Sevanagar)1.9590
2Khanapur3.9740
3Kapilapura2.6120
4Ativala2.1270
5Kolhara Khurd (Kolar K)6.1990
6Naubad3.3370
7Byalahalli3.0631.5834
8Kabirabad6.1630
9Dhummansur1.121.248
10Kamalnagar02.0807
11Sangam00.8553
12Alandi02.5039
13Kalasdhal04.1018
14Nirmanhalli04.2
15Gadawanti09.4533
16Hallikhed (B)00.8742
17maniknagar016.9617
18Anadura10.2360
Total 40.79 43.8623
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1ROW(Comprising Utility corridor)10.962725.1936
2Drain/Footpath0.26890.1067
3Paver Blocks0.45910.0295
4Carriageway2.80777.5691
5Earthen Shoulder2.06682.4334
6Toe3.50723.0926
7Rest area04.0093
8Admin Block (Toll Plaza)00.7993
9Lawn/Island00.6288
Total 20.0724 43.8623
C. Maps of forest land proposed to be diverted
Division 1. : Bidar
  (i). Area of forest land proposed to be diverted(in ha.) : 40.79   (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).
1.20.0724    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: The Project is Widening the Exiting Road Only
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 1730   (iii). Temporary Employment(Number of person-days): 1095
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?: Yes   (a). Copy of Cost-Benefit analysis:
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 application yet to be submitted
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. : Bidar
  (a). Village: Kabirabad   (b). Area(in ha.): 40.1448   (c). Copy of KML file of the patch:     View File   (d). Khasra details: Poramboku   (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
1ROW 60 m IRC code
2Administrative approval of Package 1
3Administrative approval of Package 2
4ROW 45m NH-50 Govt order
5Co-Ordinates of Geo-Reference Map
6Letter Regarding Changes made in Part-I of FORM-A in comparison with online application
7Survey wise break up details
8Undertaking from EE
9Compliance letter to 44th meeting of RO Empowered committed
10Box culvert Estimate and Drawing for Package 1
11Box culvert Estimate and Drawing for Package 2