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/41470/2019   (ii). Name of Project for which Forest Land is required : Laying of Water Pipe line and Water Tanks in the Bellary Forest Division, Chitradurga Forest Division and Tumakuru Forest Division for Drinking Water Supply Scheme To Rural Habitations And Town Of Pavagada Taluk In Tumkur District, Rural Habitations And Town Of Molakalmuru Taluk In Chitradurga District, Rural Habitations Of Challaker   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Drinking Water Supply Scheme To Rural Habitations And Town Of Pavagada Taluk In Tumkur District, Rural Habitations And Town Of Molakalmuru Taluk In Chitradurga District, Rural Habitations Of Challakere Taluk In Chitradurga District, Ujjini & 216 Habitations Of Kudligi Taluk In Ballary District, Chil   (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) : 252863   (viii). Area of forest land proposed for diversion(in ha.): 8.49   (ix). Non-forest land required for this project(in ha.): 288.603   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : SUPERINTENDING ENGINEER RURAL WATER AND SANITATION DEPARTMENT BANGALORE CIRCLE BANGALORE   (ii). Address1 : Superintending Engineer Rural Drinking Water & Sanitation Department KSDB Building, 1st Floor, Rishaldar Road, Sheshadripuram, Bangalore-560020   (iii). Address2 : NIL   (iv). State : Karnataka   (v). District : Bangalore Urban   (vi). Pin : 560020   (vii). Landmark : KSDB Building   (viii). Email address : rwsse.forest@gmail.com   (ix). Landline Telephone No. : 80-23566733   (x). Fax No. : 80-   (xi). Mobile No. : 8121396036   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Sharanappa   (ii). Middle Name: NIL   (iii). Last Name: Sulgante   (iv). Gender: Male   (v). Designation: se   (vi). Address 1: Superintending Engineer Rural Drinking Water and Sanitation Department Bangalore Circle Bangalore   (vii). Address 2: NIL   (viii). State: Karnataka   (ix). District: Bangalore Urban   (x). Tehsil: Bangalore East   (xi). Pin: 560020   (xii). Landmark: KSDB Building   (xiii). Email Address: rwsse.forest@gmail.com   (xiv). Landline Telephone No.: 80-23566733   (xv). Fax No.: NIL   (xvi). Mobile No.: 9449006215   (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.Bellary4.65660.275
2.Chitradurga3.102156.898
3.Tumkur0.73271.43
Total8.49288.603
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bellary4.65660.275
1.Chitradurga3.102156.898
3.Tumkur0.73271.43
Total8.49288.603
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Danayakanakeri-BELLARY(Dist)0.2120.026
2Thimalapura-BELLARY(Dist)1.7030.15
3Pothalakatte-BELLARY(Dist)0.1280.236
4Hulikunta 73-BELLARY(Dist)0.4250
5Shivapura-BELLARY(Dist)0.5370.09
6Jarmarli-BELLARY(Dist)0.0980.063
7Haravadi-BELLARY(Dist)0.1780.215
8Gudekote-BELLARY(Dist)0.1241.12
9Sidegallu-BELLARY(Dist)0.5440
10Ramadurga-BELLARY(Dist)0.4451.98
11Suladahalli-BELLARY(Dist)0.1050.264
12Banavikalu-BELLARY(Dist)0.0340.063
13Hosahalli-BELLARY(Dist)0.1080.546
14Jambobanahalli-BELLARY(Dist)0.0150
15Abbinahalli-CHITRADURGA(Dist)0.1020.259
16Arravindodi-CHITRADURGA(Dist)0.0570
17Bandravi-CHITRADURGA(Dist)0.2620.294
18Chalakere-CHITRADURGA(Dist)0.6321.23
19CHANNAMMANAGATHIHALLI-CHITRADURGA(Dist)0.1530.269
20Chowluru-CHITRADURGA(Dist)0.2650.259
21Jajuru kaval-CHITRADURGA(Dist)0.0890.265
22Hanagal -CHITRADURGA(Dist)0.0310.289
23Kamarada kaval-CHITRADURGA(Dist)0.2580
24Kelaginnakanive -CHITRADURGA(Dist)0.0870.214
25Malleruvu-CHITRADURGA(Dist)0.1880.284
26Melinakanive-CHITRADURGA(Dist)0.0720
27Molakalmuru-CHITRADURGA(Dist)0.130
28Mullarahalli-CHITRADURGA(Dist)0.1450.282
29Muttigaranahalli-CHITRADURGA(Dist)0.1880.19
30Nagagondanahali-CHITRADURGA(Dist)0.0540.268
31Nannival-CHITRADURGA(Dist)0.1070
32Santhegudda-CHITRADURGA(Dist)0.090.066
33Suramanhalli-CHITRADURGA(Dist)0.0850.191
34Tumukurlahalli-CHITRADURGA(Dist)0.1070
35Nidigalu-TUMAKURU(Dist)0.3490.191
36Timalapur-TUMAKURU(Dist)0.3830.15
37BALANCE AREA OF VILLAGES LEFT IN PROJECT AREA0279.149
Total 8.49 288.603
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1IPS 2 PUMP HOUSE--Chalakere-SY No: 2630.160
2WATER TANK - --Nidigalu-SY No: 10.040
3WATER TANK - --Timalapur-SY No: 80.160
4PIPE LINE -1350mm DIA4.2660
5PIPE LINE -900mm DIA0.4180
6PIPE LINE -600mm & 700mm DIA0.0580
7PIPE LINE -500mm DIA0.1390
8PIPE LINE -250mm DIA0.3250
9PIPE LINE -200mm & 150mm DIA0.050
10PIPE LINE -200mm DIA1.050
11PIPE LINE -150mm DIA0.4270
12PIPE LINE -100mm DIA0.790
13ELECTRICAL LINE TO IPS 20.1830
14APPROACH ROAD FOR PIPE LINE0.1090
15APPROACH ROAD FOR TANK0.3150
16BALANCE PROJECT AREA OUT SIDE THE PROTECTED AREA0288.603
Total 8.49 288.603
C. Maps of forest land proposed to be diverted
Division 1. : Bellary
  (i). Area of forest land proposed to be diverted(in ha.) : 4.656   (ii). Nature of the Project: Hybrid   (a). No. of patches : One
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
  (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).
1.4.656    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. : Tumkur
  (i). Area of forest land proposed to be diverted(in ha.) : 0.732   (ii). Nature of the Project: Hybrid   (a). No. of patches : One
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.
1.0.2    View File
  (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).
1.0.532    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 3. : Chitradurga
  (i). Area of forest land proposed to be diverted(in ha.) : 3.102   (ii). Nature of the Project: Hybrid   (a). No. of patches : One
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.
1.0.16    View File
  (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).
1.2.942    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? : Yes   (a). Whether Project or a part thereof is located within a Protected Area ? : Yes   (b). Status of approval of the Supreme Court : Application yet to b   (ii). Status of approval of the Standing Committee of National Board for the Wildlife(NBWL) to the Project : Application yet to be submitted
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: Two
District 1. : Vijayanagara
  (a). Village: GUDEKOTE   (b). Area(in ha.): 3.728   (c). Copy of KML file of the patch:     View File   (d). Khasra details: Sy No 129   (e). Present owner: User Agency   (f). Copy of Ownership proof:
District 2. : Bellary
  (a). Village: AVINAMADUGU   (b). Area(in ha.): 4.937   (c). Copy of KML file of the patch:     View File   (d). Khasra details: Sy No 217   (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
1Project - Concept Note
2UndertakingFRA
3Undertakings Stone Pillars
4Administrative Approval (Work Order)
5Bellary GPS Readings
6Chitradurga GPS Readings
7Tumkuru GPS Readings
8CA Land Suitability Certificate
9AREA STATEMENT ALL VILLAGE WISE
10AREA STATEMENT SY NO WISE
11AREA STATEMENT VILLAGE WISE
12Certificate for Bare Minimum Area
13Undertaking of CA Land
14Undertaking of NPV
15Undertakings CA Land Additional area
16