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/37873/2018   (ii). Name of Project for which Forest Land is required : M/S Spangle Stone Restaurant / Hotel   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 0.0020 Ha. of Forest Land for the construction of approach access to M/S Spangle Stone Restaurant / Hotel , Situated at Village Ladda, on Ludhiana to Sangrur Road, Between KM Stone No. 70 – 71 RHS, Tehsil Dhuri, Distt. Sangrur (PB). Under Forest Division 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) : 500   (viii). Area of forest land proposed for diversion(in ha.): 0.002   (ix). Non-forest land required for this project(in ha.): 0.88869   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : SPANGLE STONE RESTAURANT / HOTEL   (ii). Address1 : Spangle Stone Restaurant / Hotel village Ladda, tehsil dhuri   (iii). Address2 : NIL   (iv). State : Punjab   (v). District : Sangrur   (vi). Pin : 148034   (vii). Landmark : NIL   (viii). Email address : hotelspanglestone@gmail.com   (ix). Landline Telephone No. : 921-6728251   (x). Fax No. : 921-   (xi). Mobile No. : 9216728251   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Rajeev   (ii). Middle Name: NIL   (iii). Last Name: Kumar   (iv). Gender: Male   (v). Designation: Partner   (vi). Address 1: Rajeev Kumar Partner of Spangle Stone Restaurant / Hotel Village Ladda, Tehsil Dhuri.   (vii). Address 2: NIL   (viii). State: Punjab   (ix). District: Sangrur   (x). Tehsil: Dhuri   (xi). Pin: 148034   (xii). Landmark: NIL   (xiii). Email Address: hotelspanglestone@gmail.com   (xiv). Landline Telephone No.: 921-6728251   (xv). Fax No.: NIL   (xvi). Mobile No.: 9216728251   (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.Sangrur0.0020.88869
Total0.0020.88869
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Sangrur0.0020.88869
Total0.0020.88869
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Ladda0.0020.88869
Total 0.002 0.88869
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
11. Project Site Area00.88869
22. Area of Gate0.001380
33. Area of Curves0.000620
Total 0.002 0.88869
C. Maps of forest land proposed to be diverted
Division 1. : Sangrur
  (i). Area of forest land proposed to be diverted(in ha.) : 0.002   (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).
1.0.002    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): 20   (iii). Temporary Employment(Number of person-days): 5
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
1Application
2Power of Attorney
3Annexure A
4Affidavit
5Certificate
6Challan Receipt
7CLU
8CTP Approved Map
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
17Justification
18Map
19Minimum Use of Forest Land
20NOC from DTP in English
21NOC from DTP in Punjabi
22NOC from PDA in English
23NOC from PDA in Punjabi
24NOC from PPCB
25NOC from PWD in English
26NOC from PWD in Punjabi
27Partnership Deed
28Registration of Firm
29Registry 1 in English
30Registry 1 in Punjabi
31Registry 2 in English
32Registry 2 in Punjabi
33Registry 3 in English
34Registry 3 in Punjabi
35Registry 4 in English
36Registry 4 in Punjabi
37Sajra Plan
38Toposheet
39Undertaking for the Payment of cost of Compensatory Afforestation
40Undertaking for the Payment of cost of Trees
41Undertaking for the Payment of Net Present value
42Undertaking for the Payment of Additional amount of Net Present value
43Undertaking for the Project is private
44FRA 2006 Certificate
45Undertaking for FCA 1980