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/38636/2019   (ii). Name of Project for which Forest Land is required : Widening and Improvement of the existing road of NH - 161 A (old SH-15) to 4 lane from Karnataka - Maharashtra Border (Km0.000) to Bidar (Km 45+878)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The proposed project involves widening of an existing highway within existing right of way for a length of 45.140 km. The Project is sanctioned by MoRT&H under Bharatmala Scheme.   (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) : 84481   (viii). Area of forest land proposed for diversion(in ha.): 4.7417   (ix). Non-forest land required for this project(in ha.): 0   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : NATIONAL HIGHWAYS AUTHORITY OF INDIA GULBARGA   (ii). Address1 : PLOT NO.65, KOTHARI LAYOUT VENKATESH NAGAR GULBARGA   (iii). Address2 : NIL   (iv). State : Karnataka   (v). District : Gulbarga   (vi). Pin : 585103   (vii). Landmark : BEHIND ITI COLLEGE   (viii). Email address : piugulbarga@nhai.org   (ix). Landline Telephone No. : 8472-253756   (x). Fax No. : 8472-   (xi). Mobile No. : 7042474246   (xii). Website (if any) : www.nhai.org   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: Christovo   (ii). Middle Name: NIL   (iii). Last Name: Furtado   (iv). Gender: Male   (v). Designation: DGM   (vi). Address 1: Plot No. 65, Kothari Layout Venkatesh nagar   (vii). Address 2: Gulbarga   (viii). State: Karnataka   (ix). District: Gulbarga   (x). Tehsil: Gulbarga   (xi). Pin: 585103   (xii). Landmark: Behind ITI College   (xiii). Email Address: nhaipiugulbarga@gmail.com   (xiv). Landline Telephone No.: 8472-253756   (xv). Fax No.: NIL   (xvi). Mobile No.: 8105039958   (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.Bidar4.74170
Total4.74170
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bidar4.74170
Total4.74170
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Vanamarapalli1.34390
2Badalagaov00
3Narayanapura00
4Avarad00
5Tulajapura00
6Borala00
7Kappekeri00
8Santhapura00
9Jiraga-B00
10Sambehalli00
11Ladha00
12Musthapura00
13Kowdagaov0.15440
14Ballur J00
15Kouta K00
16Kouta B3.24340
17Islamapura00
18Janavada00
19Marakal00
20Chikkapete00
21Navadagere00
Total 4.7417 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Carriageway1.99790
2Shoulders0.84730
3Drain0.90390
4ROW0.99260
Total 4.7417 0
C. Maps of forest land proposed to be diverted
Division 1. : Bidar
  (i). Area of forest land proposed to be diverted(in ha.) : 4.7417   (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).
1.4.7417    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 an existing road with existing RoW
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 150   (iii). Temporary Employment(Number of person-days): 43800
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
1Karnataka State Notification with English Translation
2Administrative Approval and Gazette Notification of Project Road
3Land Acqisition Plan (LAP)
4Project Note
5Undertaking for Environment and CRZ clearance
6Undertaking for payment of Compensatory Afforestation
7Undertaking for use of Fly Ash
8Undertaking of no work carried out without diversion
9NHAI letter to DCF regarding re-submission of FDP
10Component Wise Break up of Forest Land
11Demand Letter
12Forest Diversion Proposal Statement
13Project Details
14Traffic Data for Past Three Years
15Undertaking for Cost Benefit Analysis
16Undertaking for Forest Area
17Undertaking for Payment Of NPV
18Undertaking by User Agency about No Court Case
19GIS Information
20Village List with Affected Forest Area
21Typical Cross Section
22NHAI Reply for letter A5 NH161ACR 122020 21 Dated 21 11 2020
23Acknowledgement from DCF and DC Bidar for Submission of Hard Copies