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/MH/ROAD/34643/2018   (ii). Name of Project for which Forest Land is required : Upgradation of Seldoh to Pawnar Section of NH 353 I (Package-II) in the state of Maharashtra to two/four lane with paved shoulder configuration.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Rehabilitation and Up-gradation of Sealdoh to Pawnar National Highway (NH-353 I) from [Design Km. 39+200 to Km. 88+620] to two/four lane with paved Shoulders configuration in the State of Maharashtra on Engineering, Procurement & Construction (EPC) Basis Contract (Package-II)   (iv). State : Maharashtra   (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) : 40437   (viii). Area of forest land proposed for diversion(in ha.): 2.143   (ix). Non-forest land required for this project(in ha.): 30.4677   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : MINISTRY OF ROAD TRANSPORT & HIGHWAYS   (ii). Address1 : Office of the Executive Engineer, National Highway Division, Public Works Department, Bunglow No. 39/1, Civil Lines, Nagpur   (iii). Address2 : NIL   (iv). State : Maharashtra   (v). District : Nagpur   (vi). Pin : 440001   (vii). Landmark : NIL   (viii). Email address : epmdonline@gmail.com   (ix). Landline Telephone No. : 712-2524829   (x). Fax No. : 712-   (xi). Mobile No. : 9341362941   (xii). Website (if any) : mahapwd.com   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: Naresh   (ii). Middle Name: Vasant   (iii). Last Name: Borkar   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Office of the Executive Engineer, National Highway Division, Public Works Department, Bunglow No.39/1, Civil Lines, Nagpur   (vii). Address 2: NIL   (viii). State: Maharashtra   (ix). District: Nagpur   (x). Tehsil: Nagpur (Urban)   (xi). Pin: 440001   (xii). Landmark: NIL   (xiii). Email Address: eenhnagpur@gmail.com   (xiv). Landline Telephone No.: 712-2524829   (xv). Fax No.: 0712   (xvi). Mobile No.: 9923750916   (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.Wardha2.14330.4677
Total2.14330.4677
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Wardha2.14330.4677
Total2.14330.4677
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Sealdoh0.01730.78
2Dorli0.19742
3Parsodi0.03490.7243
4Marda0.212.98
5Kandhali0.1611.69
6Vaygaon Be0.03220.47
7Chanki0.31721.71
8Kopra0.35831.34
9Kharangana Gode0.2491.4738
10Kamathwada0.0190.94
11Sewagram0.45540.9
12Warud0.09132
13Sindi Rly00.6668
14Digraj00.33
15Hamdapur01.7634
16Mukundpur00.53
17Waghala01.7
18Dalpatpur00.77
19Umra02.54
20Bhosa00.71
21Parsoda01.85
22Kutki01.5
23Pawnar01.0994
Total 2.143 30.4677
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
101) Sealdoh0.01730.78
202) Dorli0.19742
303)Parsodi0.03490.7243
404)Marda0.212.98
505) Kandhali0.1611.69
606)Vaygaoon Be0.03220.47
707) Chanki0.31721.71
808) Kopra0.35831.34
909) Kharangana Gode0.2491.4738
1010) Kamathwada0.0190.94
1111) Sewagram0.45540.9
1212) Warud0.09132
Total 2.143 17.0081
C. Maps of forest land proposed to be diverted
Division 1. : Wardha
  (i). Area of forest land proposed to be diverted(in ha.) : 2.143   (ii). Nature of the Project: Linear   (b). No. of Segments : Twelve
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).
1.0.0173    View File
2.0.1974    View File
3.0.0349    View File
4.0.21    View File
5.0.161    View File
6.0.0322    View File
7.0.3172    View File
8.0.3583    View File
9.0.249    View File
10.0.019    View File
11.0.4554    View File
12.0.0913    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: Package 2 is already 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): 350   (iii). Temporary Employment(Number of person-days): 146000
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?: 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
1Authorized Letter
2Project Brief Note Description of project Development proposal
3project cost
4Forest Area Statement
5Non Forest Area Statement
6Project Location Map
7Typical Cross section
8Digital Map on Google Map showing Road Alignment
9Road Alignment on Showing Toposheet Map
10Geo Referenced Map Showing Road Alignment on Village Map
11Geo Referenced Map Showing Road Alignment on Village Map Part 2
12Geo Referenced Map showing Road Alignment on Toposheet 1:50000 Scale
137/12 Marathi / English
14All Certificate and Undertaking
15Undertaking/ certificate regarding FRA/ Archeological/Minimum demand /Compensatory afforestation
16Projects Alternative option
17Part I