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/OR/IRRIG/77864/2020   (ii). Name of Project for which Forest Land is required : Kutulsingha Irrigation Project   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : This medium Irrigation Project will Provide Irrigation to 2540 Ha of CCA out of 3790 Ha GCA with annual irrigation of 3173 ha in the draught prone areas under athmallik Block   (iv). State : Orissa   (v). Category of the Proposal : Irrigation   (vi). Shape of forest land proposed to be diverted : Hybrid   (vii). Estimated cost of the Project(Rupees in lacs) : 23103.847   (viii). Area of forest land proposed for diversion(in ha.): 153.938   (ix). Non-forest land required for this project(in ha.): 25.616   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : OFFICE OF THE ENGINEER IN CHIEF (WATER RESOURCES)   (ii). Address1 : At Kharbel Nagar, Unit 5 , Bhubaneswar   (iii). Address2 : NIL   (iv). State : Orissa   (v). District : Khordha   (vi). Pin : 751001   (vii). Landmark : Secha sadan   (viii). Email address : fdpkutulsingha@gmail.com   (ix). Landline Telephone No. : 0-   (x). Fax No. : 0-   (xi). Mobile No. : 9937829320   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Kiran   (ii). Middle Name: Kumar   (iii). Last Name: Panda   (iv). Gender: Male   (v). Designation: Superintending Engineer   (vi). Address 1: Office of the Superintending Engineer, Angul Investigation Division, Inside Campus of Addl. Chief Engineer, Matia Sahi, Angul   (vii). Address 2: NIL   (viii). State: Orissa   (ix). District: Anugul   (x). Tehsil: Anugul   (xi). Pin: 759143   (xii). Landmark: Infront of Indian Oil Petrol Pump   (xiii). Email Address: fdpkutulsingha@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 7978181604   (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.Athamallik153.93825.616
Total153.93825.616
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Anugul153.93825.616
Total153.93825.616
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Taleipathar8.3693.212
2Arkhakud0.0770.299
3Nuaarakhakud0.5870.427
4Karavabhalikhaira3.5982.022
5Gunduri0.0242.067
6Anandapur2.1132.238
7Tabada0.9751.15
8Ranibandha0.2477.045
9Hatasimili0.0120.456
10Sadanandapur1.3272.601
11Alekhapur0.9152.306
12Thakurgarh0.2020.793
13Kutulsingha5.8721
14Kutulsingha RF129.620
Total 153.938 25.616
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Canal27.49925.616
2Pondage & Headworks124.5850
3Approach Raod1.6920
4Magazine House0.1610
Total 153.937 25.616
C. Maps of forest land proposed to be diverted
Division 1. : Athamallik
  (i). Area of forest land proposed to be diverted(in ha.) : 153.938   (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.
1.153.938    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): 50   (iii). Temporary Employment(Number of person-days): 30000
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 application yet to be submitted
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: 2   (iv). No. of patches: Five
District 1. : Anugul
  (a). Village: Duipani   (b). Area(in ha.): 106.232   (c). Copy of KML file of the patch:     View File   (d). Khasra details: Parbat-1   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
District 2. : Anugul
  (a). Village: Duipani   (b). Area(in ha.): 65.68   (c). Copy of KML file of the patch:     View File   (d). Khasra details: jungle ek & dui   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
District 3. : Anugul
  (a). Village: Dudipani   (b). Area(in ha.): 26.52   (c). Copy of KML file of the patch:     View File   (d). Khasra details: Parbat-2   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
District 4. : Anugul
  (a). Village: Kakharua PRF, Atanaka PRF, Ranjo PR   (b). Area(in ha.): 190.96   (c). Copy of KML file of the patch:     View File   (d). Khasra details: PRF   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
  (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.): 2540   (a). Copy of the approval of competent authority to the Catchment Area Treatment Plan (CAT Plan):   (b). Copy of the approved CAT plan:
Additional information Details
Documents
S.No Documents
Remarks
1Detail Note of the Project
2Administrative Approval
3EC Undertaking
4The compliance of the Observations