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/ROAD/14654/2015   (ii). Name of Project for which Forest Land is required : NH-200 Talchar-Dubari-Chandikhole   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The project road start Balar Chowk junction at Talchar Km 8.500 of NH-23 (301.890 of NH-200) proceeding to Pitiri junction of NH-23, near Km 302.000 of NH-200 (15.205 of NH-23) and goes up to and end Km. 428.030, the junction with NH-5 in Chandikhole town   (iv). State : Orissa   (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) : 149456   (viii). Area of forest land proposed for diversion(in ha.): 105.458   (ix). Non-forest land required for this project(in ha.): 319.171   (x). Total period for which the forest land is proposed to be diverted(in years): NIL
A-2. Details of User Agency
  (i). Name : NATIONAL HIGHWAYS ODISHA   (ii). Address1 : 301-A,3rd floor, pal Heights, plot No.J/7, Jayadev vihar Bhubaneswar-751013 Odisha   (iii). Address2 : NIL   (iv). State : Orissa   (v). District : Khordha   (vi). Pin : 751013   (vii). Landmark : Pal heights, jayadevvihar   (viii). Email address : roodisha@nhai.org   (ix). Landline Telephone No. : 674-2361570   (x). Fax No. : 674-2361770   (xi). Mobile No. : 7381062000   (xii). Website (if any) : www.nhai.org   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: Anil   (ii). Middle Name: NIL   (iii). Last Name: Dixit   (iv). Gender: Male   (v). Designation: Project Director   (vi). Address 1: 1st floor Setu bhawan, Nayapalli, unit-8, Bhubaneswar-751012 Odisha   (vii). Address 2: NIL   (viii). State: Orissa   (ix). District: Khordha   (x). Tehsil: Khordha   (xi). Pin: 751012   (xii). Landmark: Setu Bhawan, Near Chartered Accountant Institute,   (xiii). Email Address: bhu@nhai.org   (xiv). Landline Telephone No.: 674-2392720   (xv). Fax No.: 06742392740   (xvi). Mobile No.: 7381083000   (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.Cuttack34.58823.791
2.Dhenkanal70.87279.592
3.Angul015.788
Total105.458319.171
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Cuttack34.58823.791
1.Dhenkanal70.87279.592
3.Anugul015.788
Total105.458319.171
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Botlanda4.3270.036
2Damoderpur2.3870
3Pubal0.2030
4Mangalpur6.4770.863
5Nizagarh4.9557.695
6Madhapur4.9140
7Abhaypur0.6720
8Sansailo5.1264.529
9Dubri5.52710.668
10Tiplai13.8784.237
11Bamuna01.666
12Dayanabil02.149
13Balipada03.669
14Palasapithia02.526
15Basudeipur03.229
16Garhnursinhaprasad0.1883.338
17Murga00.529
18Kainsiri0.6681.592
19Balijhati0.2275.897
20Samala6.7689.112
21Bhuban Bethiapala01.403
22Natakata Bhuban1.0686.094
23Talagadia00.097
24Baunsakani00.386
25Anantapur01.087
26Chhatakhamb01.935
27Gamaragol05.406
28Bhuban Bhadaliapasi1.149.06
29Bhuban Muktapasi03.01
30Bhuban Tolakaberani01.587
31Bangura Oraf Kusia0.8819.333
32Sibalapasi1.1237.422
33Gopigadia0.5483.974
34Alutuma0.12214.49
35Malapura3.1536.944
36Nuni Oraf Rajakulakateni01.238
37Baisinga0.0496.261
38Baligorada0.4095.609
39Nuapani0.213.137
40Kantaripat2.6261.83
41Rangamatia0.1052.197
42Badasuanl.0.7416.669
43Hatuari00.267
44Sansuanala03.217
45Lokanathpur2.6016.251
46Tangarapara1.6324.99
47Mathakargola0.0323.837
48Mukutapasi0.8256.127
49Saradhapur0.4678.427
50Kanhupura2.9219.389
51Bhalumunda00.344
52Jiramalia4.0810.077
53Balbhadrapur patana00.38
54Sarang0.83614.363
55Khalpal Rerserve Forest8.480
56Pitiri0.09311.903
57Gelheikateni01.493
58Mundeilo Balabhadrapur04.201
59Hatiluchani03.303
60Dihadol04.729
61Barihapur1.74318.762
62Badjhara3.43710.833
63Kapsera0.3963.808
64Muktapasi0.97513.444
65Siarimalia7.6022.785
66Khairanali0.8450.919
67Gadaparjung08.633
Total 105.458 303.386
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Highway widening - Dhenkanal70.87279.592
2Highway widening - Cuttak34.58823.791
3Highway widening - Angul015.788
Total 105.458 319.171
C. Maps of forest land proposed to be diverted
Division 1. : Dhenkanal
  (i). Area of forest land proposed to be diverted(in ha.) : 70.87   (ii). Nature of the Project: Linear   (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).
1.70.87    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. : Cuttack
  (i). Area of forest land proposed to be diverted(in ha.) : 34.588   (ii). Nature of the Project: Linear   (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).
1.34.588    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: THE ALIGNMENT IS ALREADY EXISTING
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 30   (iii). Temporary Employment(Number of person-days): 28
F. Displacement of People due to the Project, if any
  (i). Whether Project involves displacement?: Yes   (a). Total Number of families : 1584   (b). Number of Scheduled Caste families : 110   (c). Number of Schedule Tribes families : 42   (d). Number of other families : 1432   (ii). Copy of Rehabilitation and Resettlement Plan:   (a). Copy of approval to Ministry of Tribal Affairs,Government of India to Rehabilitation and Resettlement:
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 obtained   (b). Environmental Clearance File No.: 5-41/2007-IA-III   (c). Copy of Environmental Clearance to the Project:   (d). Date of grant of Environmental Clearance to the Project: 15 May 2007
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
NIL