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/WATER/143071/2021   (ii). Name of Project for which Forest Land is required : Diversion of 0.249 Hectare of Forest Land in Ballekere village for providing water supply to Gamanahalli & other Villages , Srirangapatna Taluk, Mandya   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 0.249 Hectare of Forest Land in Survey number 98, Ballekere village for providing water supply to Gamanahalli & other Villages , Srirangapatna Taluk, Mandya   (iv). State : Karnataka   (v). Category of the Proposal : Drinking Water   (vi). Shape of forest land proposed to be diverted : Hybrid   (vii). Estimated cost of the Project(Rupees in lacs) : 2100   (viii). Area of forest land proposed for diversion(in ha.): 0.249   (ix). Non-forest land required for this project(in ha.): 8.1058   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : RURAL DRINKING WATER & SANITATION SUB DIVISION, SHRIRANGAPATANA   (ii). Address1 : RDW & SD Sub Division, Srirangapattana   (iii). Address2 : NIL   (iv). State : Karnataka   (v). District : Mandya   (vi). Pin : 571438   (vii). Landmark : Beside Canara Bank, S R Patna   (viii). Email address : aeerdwsd.srpt@gmail.com   (ix). Landline Telephone No. : 8236-252028   (x). Fax No. : 8236-   (xi). Mobile No. : 9844683295   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Kumar   (ii). Middle Name: NIL   (iii). Last Name: S   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Office of EE, RDW&S Division, Mandya   (vii). Address 2: NIL   (viii). State: Karnataka   (ix). District: Mandya   (x). Tehsil: Mandya   (xi). Pin: 571401   (xii). Landmark: Bannur Road near ZP office   (xiii). Email Address: aeerdwsd.srpt@gmail.com   (xiv). Landline Telephone No.: 8236-222363   (xv). Fax No.: NIL   (xvi). Mobile No.: 9740023109   (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.Mandya0.2498.1058
Total0.2498.1058
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Mandya0.2498.1058
Total0.2498.1058
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Ballekere (Sy No 98)0.2493.2743
2Arakere01.3281
3Aravattige Koppalu00.1005
4Bannahalli00.3129
5Bettahalli00.4683
6Gamanahalli01.61
7Gendehosahalli00.3084
8Hunasanahalli00.1134
9Madrahalli00.3858
10Nerelekere00.2041
Total 0.249 8.1058
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Existing Jack Well00.0293
2WTP01.5235
3ZBT-10.02250
4ZBT-20.02250
5Raw Water Rising Main01.6662
6Pure Water Rising main & Gravity main0.0214.8767
7Proposed Road Carriage Way0.1220.0065
8Proposed Road Shoulder0.03050.0019
9Proposed Road Drain0.03050.0017
Total 0.249 8.1058
C. Maps of forest land proposed to be diverted
Division 1. : Mandya
  (i). Area of forest land proposed to be diverted(in ha.) : 0.249   (ii). Nature of the Project: Hybrid   (a). No. of patches : Three
Patch wise details
Patch No. Area of Patch(in ha.) Kml File of PatchesTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0    View File
2.0.0225    View File
3.0.0225    View File
  (b). No. of Segments : Four
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).
1.0.021    View File
2.0.122    View File
3.0.0305    View File
4.0.0305    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 ?: No
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?: 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
1GOK ADM SANCTIONED
2Justification Letter for WTP
3Technical Approval
4GO in English Format
5Detailed Project Report
6RTC of Proposed Forest land in Ballekere Sy no 98
7Forest Area GPS Readings
8Undertaking for Laying 20 mtrs Temperory Stone Pillers
9Undertaking Letter NPV and CA
10Area with Length and Width
11Component Wise area of Forest and Non Forest
12Sy No wise Details
13Village wise area details
14Reply to shortcomings of DCF dated 07122022