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/45774/2020   (ii). Name of Project for which Forest Land is required : Manufacturing Unit of M/S Star Impact Pvt. Ltd. in Village Hakimpura, at Malerkotla   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 0.00384 HA. of Forest Land for construction of approach access to the proposed Manufacturing Unit of M/S Star Impact Pvt. Ltd. (Manufacturing of Sports Shoes and Sports Goods) in Village Hakimpura, at Malerkotla – Raikot Road, between KM Stone No. 4 - 5 L.H.S., Tehsil Malerkotla, Distt.   (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) : 2663   (viii). Area of forest land proposed for diversion(in ha.): 0.00384   (ix). Non-forest land required for this project(in ha.): 4.0298   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : STAR IMPACT PVT LTD   (ii). Address1 : STAR IMAPCT PVT LTD VILLAGE HAKIMPURA RAIKOT ROAD MALERKOTLA   (iii). Address2 : NIL   (iv). State : Punjab   (v). District : Sangrur   (vi). Pin : 148023   (vii). Landmark : NIL   (viii). Email address : segastarimpact@gmail.com   (ix). Landline Telephone No. : 1675-264530   (x). Fax No. : 1675-   (xi). Mobile No. : 9988236488   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Khalid Parvez   (ii). Middle Name: NIL   (iii). Last Name: NIL   (iv). Gender: Male   (v). Designation: CLERCK   (vi). Address 1: H.NO. 771 JAWAHAR NAGAR NEAR KAMAL CINEMA MALERKOTLA   (vii). Address 2: NIL   (viii). State: Punjab   (ix). District: Sangrur   (x). Tehsil: Malerkotla   (xi). Pin: 148023   (xii). Landmark: NIL   (xiii). Email Address: sohailqbl300@gmail.com   (xiv). Landline Telephone No.: 1675-500929   (xv). Fax No.: NIL   (xvi). Mobile No.: 9988788362   (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.Sangrur0.003844.0298
Total0.003844.0298
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Sangrur0.003844.0298
Total0.003844.0298
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Hakimpura0.003844.0298
Total 0.00384 4.0298
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
11. Project Site Area04.0298
22. Area of Gate0.0030
33. Area of Curves0.000840
Total 0.00384 4.0298
C. Maps of forest land proposed to be diverted
Division 1. : Sangrur
  (i). Area of forest land proposed to be diverted(in ha.) : 0.00384   (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).
1.0.00384    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: No Data
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 2000   (iii). Temporary Employment(Number of person-days): 0
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
3Application 1
4Annexture
5Affadavit
6Certificate
7CLU
8Detail Note of the Project
9Detail of Non Forest Land
10DGPS Map
11Form A
12FRA Certificate
13Jamabandi in English
14Jamabandi in Punjabi
15Justification for Environment Clearance
16Justification
17Letter to Range officer
18Letter to Tehsildaar
19Minimum Use of Forest Land
20NOC from Fire Department
21NOC from PWD in English
22NOC from PWD in Punjabi
23PPCB NOC Applied Documents
24Range Officer Report in English
25Range Officer Report in Punjabi
26Sajra Plan
27Sale Deed 1 in English
28Sale Deed 1 in Punjabi
29Sale Deed 2 in English
30Sale Deed 2 in Punjabi
31Sale Deed 3 in English
32Sale Deed 3 in Punjabi
33Sale Deed 4 in English
34Sale Deed 4 in Punjabi
35Sale Deed 5 in English
36Sale Deed 5 in Punjabi
37Sceduled Tribe Certificate
38Tehsildar Report
39Toposheet
40Undertaking for NOC from PPCB
41Undertaking for Payment of Additional Amount of Net Present Value
42Undertaking for Payment of Cost of Trees
43Undertaking for Payment of Net Present Value
44Undertaking for Payment of Reserve Price of Trees
45Undertaking for Payment of Reserve Price of Trees
46Undertaking for the payment of Cost of Compensatory Afforestation
47Undertaking for the project is Private
48Greening Punjab Mission Fund
49Approved Map
50Undertaking FCA 1980
51Applicant name corrected.