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/RJ/DISP/50853/2020
(ii). Name of Project for which Forest Land is required :
PROPOSED DIVERSION OF 0.60 HECT. AREA FOR CONSTRUCTION OF “CHC, NECHHWA”,SIKAR SALASAR ROAD , VILLAGE- NECHHWA, RANGE - LAXMANGARH ,TEHSIL- LAXMANGARH, DISTT- SIKAR (RAJ.)
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
PROPOSED DIVERSION OF 0.60 HECT. AREA FOR CONSTRUCTION OF “CHC, NECHHWA”,SIKAR SALASAR ROAD , VILLAGE- NECHHWA, RANGE - LAXMANGARH ,TEHSIL- LAXMANGARH, DISTT- SIKAR (RAJ.)
(iv). State :
Rajasthan
(v). Category of the Proposal :
Dispensary/Hospital
(vi). Shape of forest land proposed to be diverted :
Non Linear
(vii). Estimated cost of the Project(Rupees in lacs) :
525
(viii). Area of forest land proposed for diversion(in ha.):
0.95
(ix). Non-forest land required for this project(in ha.):
0
(x). Total period for which the forest land is proposed to be diverted(in years):
30
A-2.
Details of User Agency
(i). Name :
CHC NECHHWA,SIKAR (RAJ)
(ii). Address1 :
CHC NECHHWA SIKAR
(iii). Address2 :
NIL
(iv). State :
Rajasthan
(v). District :
Sikar
(vi). Pin :
332026
(vii). Landmark :
NIL
(viii). Email address :
chcnechhwa2020@gmail.com
(ix). Landline Telephone No. :
0-
(x). Fax No. :
0-
(xi). Mobile No. :
7737020507
(xii). Website (if any) :
NIL
(xiii). Legal status of User Agency :
State Government
A-3.
Details of Person Making Application
(i). First Name:
KULDEEP
(ii). Middle Name:
NIL
(iii). Last Name:
MAHALA
(iv). Gender:
Male
(v). Designation:
MedicalOfficer
(vi). Address 1:
CHC NECHHWA,SIKAR
(vii). Address 2:
NIL
(viii). State:
Rajasthan
(ix). District:
Sikar
(x). Tehsil:
Lachhmangarh
(xi). Pin:
332026
(xii). Landmark:
NIL
(xiii). Email Address:
chcnechhwa2020@gmail.com
(xiv). Landline Telephone No.:
0-
(xv). Fax No.:
NIL
(xvi). Mobile No.:
7737020507
(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.
Sikar Territorial
0.95
0
Total
0.95
0
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Sikar
0.95
0
Total
0.95
0
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
nechhwa
0.95
0
Total
0.95
0
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
chc nechhwa
0.6
0
Total
0.6
0
C.
Maps of forest land proposed to be diverted
Division 1. : Sikar Territorial
(i). Area of forest land proposed to be diverted(in ha.) :
0.95
(ii). Nature of the Project:
Non Linear
(a). No. of patches :
One
Patch wise details
Patch No.
Area of Patch(in ha.)
Kml File of Patches
To view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.
0.95
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:
E.
Employment likely to be generated
(i). Whether the Project is likely to generate employment ?:
Yes
(ii). Permanent/Regular Employment(Number of persons):
14
(iii). Temporary Employment(Number of person-days):
5000
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
1
NOC letters
2
Manpower Doc CHC Nechawa
3
EDS Find date-19-10-20
4
SDM letter
5
EDS-1 reply Letter
6
KHASARA MAP AND JAMABANDI
7
EDS REPLAY - 2
8
EDS reply letter date - 16.4.2021
9
EDS REPLY DATED 24.09.2021
10
DGPS map of chc
11
Digital map of chc
12
Google map of chc
13
GEo. Ref Google map of chc
14
khasara map of chc
15
UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST LAND DURING CONSTRUCTION OF CHC
16
UNDERTAKING FOR PAYMENT OF ANY OTHER COST & CONDITION
17
Breakup of Forest Land (Khasara wise,Villagewise )from chc
18
UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION
19
CERTIFICATE FOR MINIMUM USE OF FOREST LAND
20
STATEMENT SHOWING DETAILS OF FOREST AREA
21
STATEMENT SHOWING DETAILS OF non FOREST AREA
22
UNDERTAKING FOR NO FEASIBLE ALTERNATIVE & DIVERSION OF MINIMUM FOREST LAND
23
UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA
24
AREA CALCULATION SHEET OF PROPOSED CHC ,NECHHVA
25
Undertaking for CA & NPV
26
UNDERTAKING USE OF FOREST LAND
27
UNDERTAKING FOR WASTE MANAGEMENT DURING CONSTRUCTION ACTIVITY
28
UNDERTAKING FOR CONSERVATION OF FLORA/FAUNA DURING CONSTRUCTION OF CHC
29
UNDERTAKING FOR NO CHANGE’S IN STATUTORY POSITION OF DIVERTED FOREST LAND
30
UNDERTAKING FOR MUCK DISPOSAL DURING CONSTRUCTION OF CHC
31
EDS reply 23-3-2022
32
SDM letter 2022
33
EDS 7-12-2022
34
Lay out Plan of CHC area- 0.60 Ha.
35
Letter from CHC Dept.
36
EDS reply letter 31.03.2022
37
revised forecast estimate
38
revised project report
39
EDS letter 13-4-2022
40
EDS Reply dated 19-5-22
41
EDS reply letter 16/922
42
google map new
43
geo ref google map new
44
geo ref topo sheet map new
45
forest khasara map new
46
Layout plan new
47
dgps map new
48
CHC forwording leter
49
khasara breakup nre ltr
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