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/40347/2019   (ii). Name of Project for which Forest Land is required : Two Laning with Paved Shoulder of Chintamani to AP Border (length 39.8 kms), on Hybrid Annuity (DBFOMT) basis under Project KSHIP-III in Chikkaballapura & Kolar District of Karnataka State .   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Two Laning with Paved Shoulder of Chintamani to AP Border (length 39.8 kms), on Hybrid Annuity (DBFOMT) basis under Project KSHIP-III in Chikkaballapura & Kolar District of Karnataka State .   (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) : 24400   (viii). Area of forest land proposed for diversion(in ha.): 16.8014   (ix). Non-forest land required for this project(in ha.): 22.7968   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : KSHIP-TUMKUR   (ii). Address1 : Ist Floor, PWD Annexe Building, K.R. Circle.   (iii). Address2 : NIL   (iv). State : Karnataka   (v). District : Bangalore Urban   (vi). Pin : 560001   (vii). Landmark : K.R.Circle   (viii). Email address : piukship@gmail.com   (ix). Landline Telephone No. : 80-22126761   (x). Fax No. : 80-   (xi). Mobile No. : 9886633602   (xii). Website (if any) : www.kship.com   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: GANGADHAR   (ii). Middle Name: NIL   (iii). Last Name: KODLIYAVAR   (iv). Gender: Male   (v). Designation: ExecutiveEngineer   (vi). Address 1: F 149 First Floor Bharath Nagar Phase I East West College Road   (vii). Address 2: BEL Layout Magadi Road Bangaluru   (viii). State: Karnataka   (ix). District: Bangalore Urban   (x). Tehsil: Bangalore North   (xi). Pin: 560091   (xii). Landmark: Above More Departmental Store   (xiii). Email Address: forestkshiptumkur@gmail.com   (xiv). Landline Telephone No.: 816-2212313   (xv). Fax No.: NIL   (xvi). Mobile No.: 9448077123   (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.Chikkaballapura01.644
2.Kolar16.801421.1528
Total16.801422.7968
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Chikkaballapura01.644
1.Kolar16.801421.1528
Total16.801422.7968
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Madikere00.398
2Hebbari00.5219
3Imareddyhalli00.3471
4Marinayakanhalli00.2838
5Kodigivaripalli00.0095
6Gopalli00.0837
7Alavatti00.1846
8Nachagadde0.08590.1298
9Thadigol2.46811.333
10Seegalpalya00.2149
11Rajapalli00.4857
12Kamalavaripalli01.8248
13Vyshanavaripalli00.4872
14Maripalli02.8363
15K. Shettihalli01.1036
16Doddabandaralapalli01.8897
17Gundedu01.0616
18Jodi Kothapalli01.3883
19Chakapalli00.6987
20Nelavanki00.3313
21Manchineelakote02.0399
22Thammareddivaripalli00.1036
23Thopalli0.1181.7716
24Mandyala0.84120.7483
25Sunnakal0.86620
26Madrankapalli0.48430.2289
27Yendaguttapalli0.84620.0258
28Royalpad2.03980.7587
29Gontapalli9.05171.5065
Total 16.8014 22.7968
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Carraigeway1.7922.1034
2Earthwork5.93724.3661
3Shoulder2.64580.8569
4PROW(Drain & Utility)3.958313.374
5Toll Plaza2.46810.6488
6Rest Area01.4476
Total 16.8014 22.7968
C. Maps of forest land proposed to be diverted
Division 1. : Kolar
  (i). Area of forest land proposed to be diverted(in ha.) : 16.8014   (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).
1.16.8014    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): 45000
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?: 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. : Kolar
  (a). Village: Bettada Hosahalli   (b). Area(in ha.): 16.9   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 9   (e). Present owner: User Agency   (f). Copy of Ownership proof:
  (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
1Typical Cross Section
2Under taking for providing RCC Pillars
3NPV Certificate
4Mutation copy for CA Land
5Letter from DC Kolar on allocation on revenue land for CA
6Non-encumbrance certificate of CA Land
7GPS Pillar Coordinates
8Component wise breakup of Forest Area
9Survey No wise Breakup of forest area to be diverted
10Reply to DCF
11Reply to PCCF's Observation dated 16.04.2021
12Doc 01 CA undertaking
13Doc 02 Whole Village Maps
14Doc 05 Notification Hebbari Village
15Doc 06 Reply by Tehsilder Srinivaspur
16Letter to PCCF