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/Pipeline/144367/2021   (ii). Name of Project for which Forest Land is required : Shri Muktsar Sahib Virtual Pipeline   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of 0.177 Hectare of Protected Forest land various Road side strip plantation declared as protected forest for laying of 8” dia Steel Natural Gas pipeline in Shri Muktsar Sahib District of Punjab State – Request for granting permission   (iv). State : Punjab   (v). Category of the Proposal : Pipeline   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 300   (viii). Area of forest land proposed for diversion(in ha.): 0.177   (ix). Non-forest land required for this project(in ha.): 0.003   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : GUJARAT GAS LIMITED   (ii). Address1 : Shanti Sadan Soc.,Opp. Parimal Garden, Nr. Ellis Bridge   (iii). Address2 : NIL   (iv). State : Gujarat   (v). District : Ahmedabad   (vi). Pin : 380006   (vii). Landmark : Parimal Garden   (viii). Email address : parin.patel@gujaratgas.com   (ix). Landline Telephone No. : 79-66737547   (x). Fax No. : 79-   (xi). Mobile No. : 9099953937   (xii). Website (if any) : www.gujaratgas.com   (xiii). Legal status of User Agency : State PSU
A-3. Details of Person Making Application
  (i). First Name: Anish   (ii). Middle Name: NIL   (iii). Last Name: Parikh   (iv). Gender: Male   (v). Designation: DM   (vi). Address 1: 9th Floor, Avdhesh House, Opp. Shri Govind Gurudwara, S.G Highway, Ahmedabad   (vii). Address 2: NIL   (viii). State: Gujarat   (ix). District: Ahmedabad   (x). Tehsil: Ahmedabad City   (xi). Pin: 380054   (xii). Landmark: Shri Govind Gurudwara   (xiii). Email Address: anish.parikh@gujaratgas.com   (xiv). Landline Telephone No.: 79-26737557   (xv). Fax No.: NIL   (xvi). Mobile No.: 9925237539   (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.Faridkot0.1770.003
Total0.1770.003
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Shri Muktsar Sahib0.1770.003
Total0.1770.003
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Shri Muktsar Sahib0.1770.003
Total 0.177 0.003
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Along the State Highway-16 (Shri Muktsar Sahib to0.017220
2Across to State Highway-16 (Shri Muktsar Sahib to0.00060
3Along the Asphalted Road (Dr. Kehar Singh Marg)0.132660
4Along the National Highway-754 (Bathinda to Shri M0.008880
5Across to National Highway-754 (Bathinda to Shri M0.000720
6Along the National Highway-754 (Bathinda to Shri M0.016920
Total 0.177 0
C. Maps of forest land proposed to be diverted
Division 1. : Faridkot
  (i). Area of forest land proposed to be diverted(in ha.) : 0.177   (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).
1.0.177    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: Proposed pipeline will be laid along & across to v
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 0   (iii). Temporary Employment(Number of person-days): 10
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
1Company Certificate for GGL
2Project Authorization
3Detailed Note
4Undertaking for All Conditions
5Undertaking for CA
6Undertaking for Depth Width
7Undertaking for EC
8Undertaking for FRA
9Undertaking for No Pending Proposal
10Undertaking for No Tree Cutting
11Undertaking for NPV
12Undertaking for Other NOC
13Geo reference Map
14Linear plan with forest area are attached herewith. As per the discussion with Nodal Officer during the meeting approval of land owning agency is not required. Undertaking is already attached.
15Payment towards GPM fee & BG submitted to DFO, Shri Muktsar Sahib. Kindly do the needful for further processing.
16Clarification against essential details sought by your good office is attached herewith. We therefore request you to consider the application and do the needful for granting permission at the earliest possible.
17Compliance regarding submission of NOC received from other land owning agencies are attached herewith.
18Renew BG Submitted to DFO Shri Muktsar Sahib