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/40747/2019
(ii). Name of Project for which Forest Land is required :
2 Laning of Gadag to Honnali Section of SH-57 and SH-26 in the State of Karnataka
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
It involves two Laning with Paved Shoulder from km 105.500 to Km 205.290 of SH 57 and Km 215.335 to Km 253.713 of SH-26 from Gadag to Honnali in the State of Karnataka on Hybrid Annuity Basis
(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) :
80500
(viii). Area of forest land proposed for diversion(in ha.):
5.1564
(ix). Non-forest land required for this project(in ha.):
231.2146
(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
(ii). Address1 :
Karnataka State Highways Improvement Project Project Implementation Unit PWD Offices Annexe Building K R Circle, Bangalore
(iii). Address2 :
NIL
(iv). State :
Karnataka
(v). District :
Bangalore Urban
(vi). Pin :
560001
(vii). Landmark :
NIL
(viii). Email address :
pdkship@gmail.com
(ix). Landline Telephone No. :
80-22226262
(x). Fax No. :
80-22229666
(xi). Mobile No. :
9916976505
(xii). Website (if any) :
www.kship.in/en
(xiii). Legal status of User Agency :
State Government
A-3.
Details of Person Making Application
(i). First Name:
Anand
(ii). Middle Name:
NIL
(iii). Last Name:
HS
(iv). Gender:
Male
(v). Designation:
EE
(vi). Address 1:
Executive Engineer, KSHIP Division Radhagiridhari Complex J P N Cross Road
(vii). Address 2:
Shimogha
(viii). State:
Karnataka
(ix). District:
Shimoga
(x). Tehsil:
Shimoga
(xi). Pin:
577201
(xii). Landmark:
Near Shimogga Opticals
(xiii). Email Address:
eekshipshmg@gmail.com
(xiv). Landline Telephone No.:
8182-255042
(xv). Fax No.:
NIL
(xvi). Mobile No.:
9844437174
(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.
Gadag
2.8748
101.2094
2.
Haveri
2.2816
121.9521
3.
Davanagere
0
8.0531
Total
5.1564
231.2146
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Gadag
2.8748
101.2094
1.
Haveri
2.2816
121.9521
3.
Davanagere
0
8.0531
Total
5.1564
231.2146
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
1. Gadag (Gadag)
0
2.517
2
2 Kalasapura (Gadag)
0
1.274
3
3 Mallasamudra (Gadag)
0
2.0719
4
4 Nagavi (Gadag)
0
1.679
5
5 Nabhapura (Gadag)
0
4.188
6
6 Beladhadi (Gadag)
0
6.082
7
7 Shirunja (Gadag)
0
8.166
8
8 Yalishirur (Gadag)
0
6.187
9
9 Soratur (Gadag)
0
6.555
10
10 Shirahatti (Gadag)
0
10.54
11
11 Chabbi (Gadag)
0
6.62
12
12 Devihalla (Gadag)
1.0591
1.8313
13
13 Bellatti (Gadag)
0
7.729
14
14 Narayanapura (Gadag)
0
9.789
15
15 Hosur (Gadag)
0.2601
2.9801
16
16 Tangoda (Gadag)
0.0409
4.0724
17
17 Algilwada (Gadag)
0.134
13.3315
18
18 Itagi (Gadag)
1.3807
5.5962
19
19 Belavagi (Haveri)
0
10.958
20
20 Havanur (Haveri)
0
2.079
21
21 Kasaba Guttal (Haveri)
0
11.476
22
22 Mevundi (Haveri)
0
2.436
23
23 Guyilagundi (Haveri)
0
4.872
24
24 Thimmapur (Haveri)
0
1.214
25
25 Teredahalli (Haveri)
0
5.827
26
26 Nukapura (Haveri)
0
7.44
27
27 Gudagoor (Haveri)
0.9825
0.057
28
28 Honnati (Haveri)
0
4.192
29
29 Gudda Guddapura (Haveri)
0
2.063
30
30 Guddada Anweri (Haveri)
0
4.876
31
31 Hullatti (Haveri)
0
0.959
32
32 Ranebennur (Haveri)
0
9.756
33
33 Kerimallapura (Haveri)
0.1013
0.747
34
34 Halageri (Haveri)
0
2.12
35
35 Anatharavalli (Haveri)
0
3.286
36
36 Kuppelur (Haveri)
0
9.44
37
37 Sanna Sangapura (Haveri)
0
2.98
38
38 Bada Basapura (Haveri)
0
4.19
39
39 Thimmenahalli (Haveri)
0
1.68
40
40 Alladakatte (Haveri)
0
0.016
41
41 Godihala (Haveri)
0
2.509
42
42 Malanayakanahalli (Haveri)
0
0.457
43
43 Thumminakatte
0
4.585
44
44 Yalabadagi (Haveri)
0
2.039
45
45 Kirigeri (Haveri)
0
2.521
46
46 Chatnalli (Haveri)
0
9.376
47
47 Puradakeri (Haveri)
0
3.261
48
48 Hallur (Haveri)
1.1978
2.823
49
49 Shankaranahalli (Haveri)
0
1.717
50
50 Holeharalahalli (Davangere)
0
2.116
51
51 Hanumasagara (Davangere)
0
3.277
52
52 Konayakanahalli (Davangere)
0
0.101
53
53 Anjanapura (Davangere)
0
0.926
54
54 Honnali (Davangere)
0
1.633
Total
5.1564
231.2144
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Carriageway
0.898919423472889
63.8926
2
PROW (drain & Utility)
3.8280754975978
136.5857
3
Toll Plaza & Rest Area
0
12.4598
4
Shoulder
0.429405078929307
18.2765
Total
5.1564
231.2146
C.
Maps of forest land proposed to be diverted
Division 1. : Gadag
(i). Area of forest land proposed to be diverted(in ha.) :
2.8748
(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.
2.8748
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:
Division 2. : Haveri
(i). Area of forest land proposed to be diverted(in ha.) :
2.2816
(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.
2.2816
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:
Liner project; expansion of existing road
E.
Employment likely to be generated
(i). Whether the Project is likely to generate employment ?:
Yes
(ii). Permanent/Regular Employment(Number of persons):
0
(iii). Temporary Employment(Number of person-days):
216000
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 ? :
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:
2
(iv). No. of patches:
Two
District 1. : Gadag
(a). Village:
Shantagiri
(b). Area(in ha.):
4.0063
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
125/3
(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:
District 2. : Haveri
(a). Village:
Baradi
(b). Area(in ha.):
2.5292
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
1/1A
(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
1
UndertakingforCA
2
Typical Cross Section
3
Authorisation Certificate
4
Payment cerfiticate for FA
5
Undertaking cerfiticate for CA Land
6
Component-Wise Breakup of Forest Area
7
Proposed Forest Diversion Area (HAVER DIVISION)
8
Proposed Forest Diversion Boundary Coordinates (HAVER DIVISION)
9
Villages wise Breakup Revised
10
District wise breakup Revised
11
Details of Divisions involved Revised
12
Component wise breakup Revised
13
Gadag Forest Diversion Boundary Coordinates
14
Gadag Div Forest Diversion Area
15
Revised forest Diversion Area and C A Land Details 5.1564 Ha
16
Proposed Compensatory Afforestation Boundary Coordinates
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