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/71917/2020   (ii). Name of Project for which Forest Land is required : Permission For M/S Canadian Villa On Rajindergarh to Baras Road At Village Dhollan , Teh & Distt. Fatehgarh Sahib , Punjab .   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 0.0060 hec. of Forest Land For the Permission for Approach Road To M/S Canadian Villa on Rajindergarh to Baras Road KM 5 To 6 L/S At Village Dhollan , Teh. & Distt. Fatehgarh Sahib , Punjab .   (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) : 40   (viii). Area of forest land proposed for diversion(in ha.): 0.006   (ix). Non-forest land required for this project(in ha.): 1.1   (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 CANADIAN VILLA   (ii). Address1 : M/s Canadian vIlla on Rajindergarh to Baras Road KM 5 to 6 L/S village Dhollan , Teh & Distt Fatehgarh sahib , Punjab .   (iii). Address2 : NIL   (iv). State : Punjab   (v). District : Fatehgarh Sahib   (vi). Pin : 140406   (vii). Landmark : NIL   (viii). Email address : canadianvilla123@gmail.com   (ix). Landline Telephone No. : 123-234123   (x). Fax No. : 123-   (xi). Mobile No. : 9888777294   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Karamjit   (ii). Middle Name: NIL   (iii). Last Name: Singh   (iv). Gender: Male   (v). Designation: Owner   (vi). Address 1: Karamjit Singh S/O Sh. Baldev Singh , R/o Village Dhunda , Teh Bassi Patana , District Fatehgarh sahib Punjab .   (vii). Address 2: NIL   (viii). State: Punjab   (ix). District: Fatehgarh Sahib   (x). Tehsil: Bassi Pathana   (xi). Pin: 140412   (xii). Landmark: NIL   (xiii). Email Address: canadianvilla123@gmail.com   (xiv). Landline Telephone No.: 12-123421   (xv). Fax No.: NIL   (xvi). Mobile No.: 9888777294   (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.Patiala0.0061.1
Total0.0061.1
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Fatehgarh Sahib0.0061.1
Total0.0061.1
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Dhollan0.0061.1
Total 0.006 1.1
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Entry & Exit0.0060
2Project Site01.1
Total 0.006 1.1
C. Maps of forest land proposed to be diverted
Division 1. : Patiala
  (i). Area of forest land proposed to be diverted(in ha.) : 0.006   (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).
1.0.006    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): 10   (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? : No
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
1Form A
2Brief note on locating the project Checklist no 4
3Statement showing details of Non Forest Area Checklist no 8
4Justification of Project Site Checklist no 10
5Certificate of Minimum Use of Forest land Checklist no 11
6Undertaking For Payment of cost of Compensatory Afforestation Checklist no 12
7Undertaking For Payment of NPV Checklist no 13
8Details of Built up Area of Project Checklist no 23
9Environmental clerance certiicate no 24
10Undertaking For Non Forest Land
11Undertaking For Reserve price of trees
12Undertaking For Private Or Govt Works
13Undertaking For Effectivness Schedule Tribes Certicate
14Undertaking for Add NPV
15Undertaking For DC Schedule Tribes
16Affidavit
17FRA Certificate
18Undertaking for Penal NPV forest area
19Annexure
20certificate of project is not closed under PLP 1900
21certificate on Agree to bear cost of Compensatory Afforestation and NPV
22Self Declaration
23Part 1
24Akshajra
25PWD TRANSALTION
26PWD MAP
27Sale deed
28CLU
29Zamabandi Fard
30Zamabandi Fard Translation
31Notification
32Pollution NOC
33PWD NOC
34Forest Map
35Survey map of India
36Undertaking for providing cost of nonForest Land equivalent to the forest area being diverted Under FCA1980
37Processing Fess 1000 Receipt
38Forwarding Letter
39Geo Reference Map