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/ROAD/35959/2018   (ii). Name of Project for which Forest Land is required : “Construction of CC.Road from Triveni road to Brahmani Mata Temple ”   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : “Construction of CC.Road from Triveni road to Brahmani Mata Temple ”Applied area -0.5004 Brahmani Mata Temple is old temple Religious place hence it is necessary approach road up to temple   (iv). State : Rajasthan   (v). Category of the Proposal : Road   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 0.36   (viii). Area of forest land proposed for diversion(in ha.): 0.5004   (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): 99
A-2. Details of User Agency
  (i). Name : PUBLIC WORK DEPARTMENT   (ii). Address1 : Jacob Road, Ajmer Road, Jaipur   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Jaipur   (vi). Pin : 302006   (vii). Landmark : Opposite to Jaipur Club   (viii). Email address : aceppp.pwd@rajasthan.gov.in   (ix). Landline Telephone No. : 141-5110547   (x). Fax No. : 141-   (xi). Mobile No. : 9414985400   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: AJEET   (ii). Middle Name: KUMAR   (iii). Last Name: JANGIR   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: PWD Distt. Division Shahpura, Jaipur   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Jaipur   (x). Tehsil: NIL   (xi). Pin: 303103   (xii). Landmark: NH-08, Km 201th Shahpura   (xiii). Email Address: eepwdshahpura@gmail.com   (xiv). Landline Telephone No.: 1422-225372   (xv). Fax No.: NIL   (xvi). Mobile No.: 9414503274   (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
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
1InprincipleFP/RJ/ROAD/6952/2014P.1(33)Forest/20150.310.3103 Mar 2015
2InprincipleFP/RJ/ROAD/6983/2014P.1(37)Forest/20150.50.503 Mar 2015
3ApprovedFP/RJ/ROAD/23593/20178B/RAJ/06/13/2017/FC1.79011.790104 Oct 201705 Oct 2020
4ApprovedFP/RJ/ROAD/17799/2016F.1(16)FOREST/20170.980.9814 Mar 201730 May 2019
5ApprovedFP/RJ/ROAD/6952/20141(33)Forest/20150.310.3103 Mar 201504 May 2019
6ApprovedFP/RJ/ROAD/6983/20141(37)Forest/20150.50.503 Mar 201513 Jan 2021
Total 4.3901 4.3901
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.Jaipur (North) Territorial0.50040
Total0.50040
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Jaipur0.50040
Total0.50040
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Village Devipura0.50040
Total 0.5004 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Triveni Road to Bramani Mata Temple Road0.50040
Total 0.5004 0
C. Maps of forest land proposed to be diverted
Division 1. : Jaipur (North) Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.5004   (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).
1.0.5004    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: this prevalent route.
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): 218
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
1Administrative and Financial Sanction
2Technical Sanction
3Project Report
4Authorization Letter
5Cross Section
6Gazet Notification
7Gram Panchyat Noc
8Gram Sabha Meeting copy
9SDM NOC COPY
10Jamabandi Copy
11KHASRA MAP
12Linear chart
13FRA CERTIFICATE
14EDS REPLY LETTER
15EDS REPLY LETTER-16-12-2019
16EDS Reply for Triveni road to Brahmani Mata Temple -06-03-2020
17CERTIFICATE FOR MINIMUM USE OF FOREST LAND (CHECK LIST SERIAL NUMBER-11)
18STATEMENT SHOWING DETAILS OF FORESTAREAPROPOSED FOR DIVERSION (CHECK LIST SERIAL NUMBER-07)
19UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY (CHECK LIST SERIAL NUMBER-12)
20UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OFFOREST AREA (CHECK LIST SERIAL NUMBER-13)
21UNDERTAKING FOR CONSERVATION OF FLORA-FAUNA AND WILDLIFE ANIMALS
22UNDERTAKING FOR MUCK DISPOSAL DURING CONSTRUCTION OF ROAD
23UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED
24UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST LAND DURING CONSTRUCT ROAD
25UNDERTAKING FOR WASTE MANAGEMENT DURING CONSTRUCTION ACTIVITY
26BAR CHART
27DIGITAL MAP SHOWING FOR REQUIRED FOREST LAND COORDIANTES AN FOREST BOUNDARY AND PROPOSED ROAD ALIGNMENT SCALE 1:4000
28GOOGLE IMAGERY MAP
29GEO-REFERENCED MAP SHOWING SURVEY OF INDIA TOPOSHEET WITH FOREST BOUNDARY AND PROPOSED ROAD ALIGNMENT SCALE 1:50000
30Revised Acknowledgment Slip-17-07-2020
31EDS REPLY -24-11-2020
32UNDERTAKING for Plastic carry bags will not be used