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/MP/IRRIG/139995/2021
(ii). Name of Project for which Forest Land is required :
ISP KALISINDH PHASE-II MICRO LIFT IRRIGATION PROJECT SCHEME (PIPELINE)
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
Project provides irrigation facilities to 270 villages of shajapur and rajgarh district
(iv). State :
Madhya Pradesh
(v). Category of the Proposal :
Irrigation
(vi). Shape of forest land proposed to be diverted :
Linear
(vii). Estimated cost of the Project(Rupees in lacs) :
461934
(viii). Area of forest land proposed for diversion(in ha.):
147.09
(ix). Non-forest land required for this project(in ha.):
40
(x). Total period for which the forest land is proposed to be diverted(in years):
99
A-2.
Details of User Agency
(i). Name :
EE ND DIVISION NO TWENTY MANDLESHWAR
(ii). Address1 :
Narmada Development Division number 20 Mandleshwar
(iii). Address2 :
NIL
(iv). State :
Madhya Pradesh
(v). District :
Khargaone
(vi). Pin :
451221
(vii). Landmark :
Near Snake Temple
(viii). Email address :
eenvda20mdl1@gmail.com
(ix). Landline Telephone No. :
7283-2333440
(x). Fax No. :
7283-
(xi). Mobile No. :
8959116615
(xii). Website (if any) :
NIL
(xiii). Legal status of User Agency :
State Government
A-3.
Details of Person Making Application
(i). First Name:
T
(ii). Middle Name:
R
(iii). Last Name:
Pachore
(iv). Gender:
Male
(v). Designation:
ExecutiveEngineer
(vi). Address 1:
Narmada Development Division number 20 Mandleshwar
(vii). Address 2:
NIL
(viii). State:
Madhya Pradesh
(ix). District:
Khargaone
(x). Tehsil:
maheshwar
(xi). Pin:
451221
(xii). Landmark:
Near Snake Temple
(xiii). Email Address:
eeenvda20mdl@gmail.com
(xiv). Landline Telephone No.:
7283-2333440
(xv). Fax No.:
NIL
(xvi). Mobile No.:
9425046676
(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.
Khandwa(T)
46.989
0
2.
Dewas(T)
100.101
40
Total
147.09
40
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Khandwa
46.989
0
1.
Dewas
100.101
40
Total
147.09
40
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
Boranya
11.709
0
2
Devasya
7.413
0
3
Tumri Kheda
13.91
0
4
Bajrang garh
0
2.183
5
Dehri
7.093
0.837
6
Bor Khalya
0
24.418
7
Piplya Khari
5.062
0
8
Rupalipura
0
10.827
9
Gadiya
0
1.735
10
Singladeh
31.228
0
11
Kharadi
23.686
0
12
Banka Palash (Viraan)
46.989
0
Total
147.09
40
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Single Pipeline (4.6 mtr. dia) with Transmission L
111.6475
20.25
2
Single Pipeline (4.6 mtr. dia)
19.2625
9.25
3
Pump House No. 1
5.94
0
4
Pump House No. 2
0
5
5
Pump House No. 3
7.19
0
6
Pump House No. 4
0
5
7
BPT 1
0.5
0
8
BPT 2
0.5
0
9
DC
0
0.5
10
Approach Road to PH 3
0.5
0
11
Approach Road to BPT-1
0.5
0
12
Approach Road to BPT-2
1.05
0
Total
147.09
40
C.
Maps of forest land proposed to be diverted
Division 1. : Dewas(T)
(i). Area of forest land proposed to be diverted(in ha.) :
100.101
(ii). Nature of the Project:
Linear
(b). No. of Segments :
Eleven
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.
60.421
View File
2.
2.19
View File
3.
1.221
View File
4.
5.92
View File
5.
1.846
View File
6.
7.475
View File
7.
11.788
View File
8.
7.19
View File
9.
0.5
View File
10.
0.5
0
11.
1.05
1
(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. : Khandwa(T)
(i). Area of forest land proposed to be diverted(in ha.) :
46.989
(ii). Nature of the Project:
Linear
(b). No. of Segments :
Six
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.
0.725
View File
2.
1.428
View File
3.
37.896
View File
4.
5.94
View File
5.
0.5
View File
6.
0.5
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):
150
(iii). Temporary Employment(Number of person-days):
1500
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 ? :
Yes
(a). Status of the Environmental Clearance to the Project:
EC under process
(ii). Environmental Clearance File No.:
7044/2020
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:
1
(iv). No. of patches:
Five
District 1. : Shajapur
(a). Village:
Favaka
(b). Area(in ha.):
39.54
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
816/1 to 816/19, 816/822
(e). Present owner:
User Agency
(f). Copy of Ownership proof:
District 2. : Shajapur
(a). Village:
Kadula
(b). Area(in ha.):
25.48
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
2243/3, 2244, 2245, 2246, 2247
(e). Present owner:
User Agency
(f). Copy of Ownership proof:
District 3. : Shajapur
(a). Village:
Malyahedi
(b). Area(in ha.):
13.44
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
939, 941
(e). Present owner:
User Agency
(f). Copy of Ownership proof:
District 4. : Shajapur
(a). Village:
Mangliya
(b). Area(in ha.):
44.76
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
72, 73, 44/3, 182, 220, 285/4, 736/4, 239
(e). Present owner:
User Agency
(f). Copy of Ownership proof:
District 5. : Shajapur
(a). Village:
Bandahedi
(b). Area(in ha.):
28
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
103, 313, 435
(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:
M.
Hydel/Irrigation/Multipurpose Project
(i). Installed power generation capacity of the Project(in MW):
0
(ii). Total command area of the Project(in ha.):
0
Additional information Details
Documents
S.No
Documents
Remarks
1
2
INDEX MAP
3
Reply letter dated 16-04-2021
4
CA undertaking
5
Collector Shajapur CA Order
6
Component wise breakup
7
Coordinate
8
Cost Benefit Analysis
9
Extra NPV
10
Minimume Forest Area
11
Muk Disposal
12
NPV
13
SOI KALISINDH II FULL_WITH COMPT
14
SOI KALISINDH II KHANDWA_WITH COMPT
15
SOI KALISINDH II DEWAS_WITH COMPT Signed
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