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/WATER/145554/2021   (ii). Name of Project for which Forest Land is required : Rajghat Multi Village Scheme   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The Rajghat scheme includes supply of treated drinking water to the rural area of Ashok nagar district under the Jal Jeevan Mission scheme.   (iv). State : Madhya Pradesh   (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) : 2000   (viii). Area of forest land proposed for diversion(in ha.): 3.885   (ix). Non-forest land required for this project(in ha.): 0   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : MP JAL NIGAM MARYADIT   (ii). Address1 : khedapti road phe colony phoolbag gwalior   (iii). Address2 : NIL   (iv). State : Madhya Pradesh   (v). District : Gwalior   (vi). Pin : 474001   (vii). Landmark : NIL   (viii). Email address : gmgwalior.mpjalnigam@mp.gov.in   (ix). Landline Telephone No. : 0-   (x). Fax No. : 0-   (xi). Mobile No. : 8174912230   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State PSU
A-3. Details of Person Making Application
  (i). First Name: M   (ii). Middle Name: K   (iii). Last Name: MUDGAL   (iv). Gender: Male   (v). Designation: General Manager   (vi). Address 1: house no 59,ward no. 20, near graphics institute ,patrkaar colony guna   (vii). Address 2: NIL   (viii). State: Madhya Pradesh   (ix). District: Guna   (x). Tehsil: NIL   (xi). Pin: 473001   (xii). Landmark: NIL   (xiii). Email Address: gmgwalior.mpjalnigam@mp.gov.in   (xiv). Landline Telephone No.: 0-7542350028   (xv). Fax No.: NIL   (xvi). Mobile No.: 9826463816   (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
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
1Under Processing at State Government1455544.260
Total 4.26 0
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.Ashok Nagar(T)3.8850
Total3.8850
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Ashoknagar3.8850
Total3.8850
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Ashoknagar3.8850
Total 3.885 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Pipe Line 20.19380
2Chanderi MBr0.240
3Mundi Pahad MBR lower0.160
4Mundi Pahad MBR upper0.160
5Approach Road Chanderi MBR0.180
6Mundi Pahad MBR Road upper0.480
7Mundi Pahad MBR Road lower0.480
8Pipe Line1.9910
Total 3.8848 0
C. Maps of forest land proposed to be diverted
Division 1. : Ashok Nagar(T)
  (i). Area of forest land proposed to be diverted(in ha.) : 3.885   (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.
1.3.885    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    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): 0   (iii). Temporary Employment(Number of person-days): 150
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? : Yes
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: No Data
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 ?: Yes   (a). Reason Category: CA Will be raised on degraded forest land as well as on land provided by User Agency   (b). Degraded forest area on which CA has to be raised by forest department(in ha.): 3.885   (c). Area of non-forest or Revenue forest land required to be provided by User Agency for raising Compensatory Afforestation(in ha.): 8.466   (iii). No. of districts involved for raising Compensatory Afforestation: 1   (iv). No. of patches: One
District 1. : Ashoknagar
  (a). Village: Baghanari   (b). Area(in ha.): 8.466   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 536,538   (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
1
2acknowledgement receipt of NPV Amount Submission
3Letter No 2118 , compliance regarding CA LAnd
4Khasra 536
5Khasra 538
6CA Land Allotted Letter From Collector Ashoknagar
7Muck Restoration plan
8Justification counter sign by DFO
9Compliance report letter
10AA Order Copy
11Component wise breakup
12Comparative statement
13MUck Restoration Plan
14Reply of querry raised via letter no 1637 dated 15.03.2024
15copliance letter of querry raised on dated 8/4/2024
16NOC File
17Alternate Route 1
18Alternate Route 2
19Compliance letter against query raised on 22.04.2024 via DFO Ashoknagar.
20Layout
21alternate route one 145554
22alternate route two 145554