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/PB/Approach/34886/2018   (ii). Name of Project for which Forest Land is required : Construction of Approach Access to M/S Madhav Agro Foods at Village Dhadrian   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 0.002784 Hec. of Forest Land for construction of Approach access to M/S. Madhav Agro Foods, situated at Village Dhadrian on Cheema – Dhadrian Road, Tehsil & Distt. Sangrur.   (iv). State : Punjab   (v). Category of the Proposal : Approach Access   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 180   (viii). Area of forest land proposed for diversion(in ha.): 0.002784   (ix). Non-forest land required for this project(in ha.): 0.80937   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : M/S MADHAV AGRO FOODS   (ii). Address1 : Madhav Agro Foods Cheema Road, Village Dhadrian. Tehsil and Distt. Sangrur   (iii). Address2 : NIL   (iv). State : Punjab   (v). District : Sangrur   (vi). Pin : 148106   (vii). Landmark : NIL   (viii). Email address : mintubansal880@gmail.com   (ix). Landline Telephone No. : 941-7117880   (x). Fax No. : 941-   (xi). Mobile No. : 9417117880   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Mintu   (ii). Middle Name: NIL   (iii). Last Name: Bansal   (iv). Gender: Male   (v). Designation: Proprietor   (vi). Address 1: M/S Madhav Agro Foods, Cheema Road, Village Dhadrian.   (vii). Address 2: NIL   (viii). State: Punjab   (ix). District: Sangrur   (x). Tehsil: Sangrur   (xi). Pin: 148106   (xii). Landmark: NIL   (xiii). Email Address: mintubansal880@gmail.com   (xiv). Landline Telephone No.: 941-7117880   (xv). Fax No.: NIL   (xvi). Mobile No.: 9417117880   (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.Sangrur0.0027840.80937
Total0.0027840.80937
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Sangrur0.0027840.80937
Total0.0027840.80937
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Dhadrian0.0027840.80937
Total 0.002784 0.80937
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
11. Area of the Gate0.00240
22. Area of Curve 10.0001920
33. Area of Curve 20.0001920
44. Project Site Area00.809357
Total 0.002784 0.809357
C. Maps of forest land proposed to be diverted
Division 1. : Sangrur
  (i). Area of forest land proposed to be diverted(in ha.) : 0.002784   (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).
1.0.002784    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): 50
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? : 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
1Authority Letter
2Application
3Annexure A
4Affidavit
5Certificate
6Challan receipt
7CLU in English
8CLU in Punjabi
9Detail Note of the project
10Detail of non Forest Land
11Drawing
12Form A
13Geo Reference Map
14Jamabandi in English
15Jamabandi in Punjabi
16Justification for NOC from Environment Clearance in not required
17Justification
18Minimum Use of Forest Land
19NOC from PWD in English
20NOC from PWD in Punjabi
21Range Officer Report
22Registry in English
23Registry in Punjabi
24Schedule Tribe Certificate
25Toposheet
26Undertaking for the Payment of Cost of Trees
27Undertaking for the Payment of Additional amount of Net Present Value
28Undertaking for the Payment of Net Present Value
29Undertaking for the Payment cost of Compensatory Afforestation
30Undertaking for the Project is Private
31NOC from PPCB
32Air Pollution Certificate
33Water Pollution Certificate
34Undertaking FCA
35DC Rate
36PPCB
37PPCB NOC Air
38PPCB NOC water