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/40754/2019   (ii). Name of Project for which Forest Land is required : Construction of Approach Road for Proposed Nayara Energy Limited (Formerly Essar Oil Ltd.) Retail Outlet on Suratgarh - Sri Ganganagar NH-62 ,Between Chainage ms stone 209/390 -209/430(RHS)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of Approach Road for Proposed Nayara Energy Limited (Formerly Essar Oil Ltd.) Retail Outlet on Suratgarh - Sri Ganganagar NH-62 ,Between Chainage ms stone-209/390 -209/430(RHS) at Village- 7BLW, Tehsil-Pilibanga, District Hanumangarh.   (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) : 45   (viii). Area of forest land proposed for diversion(in ha.): 0.1685   (ix). Non-forest land required for this project(in ha.): 0.202   (x). Total period for which the forest land is proposed to be diverted(in years): 19.90
A-2. Details of User Agency
  (i). Name : NAYARA ENERGY LIMITED   (ii). Address1 : 105-106, Hukumraj Tower, Residency Road,   (iii). Address2 : Nr. Polytechnic Collage   (iv). State : Rajasthan   (v). District : Jodhpur   (vi). Pin : 342011   (vii). Landmark : NIL   (viii). Email address : nayaraenergygusaisar@gmail.com   (ix). Landline Telephone No. : 291-2655511   (x). Fax No. : 291-   (xi). Mobile No. : 7680007986   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Prabhakar   (ii). Middle Name: NIL   (iii). Last Name: Maheshwari   (iv). Gender: Male   (v). Designation: DivisionalManagerBD   (vi). Address 1: 105-106,Hukumraj Tower,Residency Road ,Jodhpur   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Jodhpur   (x). Tehsil: Jodhpur   (xi). Pin: 342011   (xii). Landmark: Near Politechnic College   (xiii). Email Address: prm.ghanghas@gmail.com   (xiv). Landline Telephone No.: 291-2655511   (xv). Fax No.: NIL   (xvi). Mobile No.: 9460947826   (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.Hanumangarh Territorial0.16850.202
Total0.16850.202
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Hanumangarh0.16850.202
Total0.16850.202
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1CHAK 7BLW0.16850.202
Total 0.1685 0.202
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Construction of Approach Road Deceleration Lane (L0.05880.021
2Construction of Approach Road Acceleration Lane (R0.07120.021
3Front Side Service Road0.03850
4Construction of Retail Outlet00.16
Total 0.1685 0.202
C. Maps of forest land proposed to be diverted
Division 1. : Hanumangarh Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.1685   (ii). Nature of the Project: Linear   (b). No. of Segments : Three
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).
1.0.0588    View File
2.0.0712    View File
3.0.0385    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: Entire Road side land declared as PF
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 8   (iii). Temporary Employment(Number of person-days): 200
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
1AUTHORIZATION LETTER.PDF
2LOI LETTER F.pdf
3AREA CALCULATION SHEET.pdf
4JUSTIFICATION FOR LOCATING THE PROJECT IN FOREST AREA.pdf
5UNDERTAKING FOR CONSERVATION OF FLORA-FAUNA AND WILDLIFE ANIMALS DURING ROAD CONSTRUCTION
6UNDERTAKING FOR FRA CERTIFICATE
7UNDERTAKING FOR MUCK DISPOSAL DURING CONSTRUCTION OF ROAD
8UNDERTAKING FOR NO CHANGE’S IN STATUTORY POSITION OF DIVERTED FOREST LAND
9UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST LAND DURING CONSTRUCT ROAD
10UNDERTAKING FOR WASTE MANAGEMENT DURING CONSTRUCTION ACTIVITY
11BAR CHART
12CERTIFICATE FOR MINIMUM USE OF FOREST LAND
13UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION
14UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA
15KHASRA AND JAMABANDI
16Map shwoing for Georeferenced Toposheet Map 50000 scale
17Georeferenced Digital Map with Coordinates
18Georeferenced Google Map with Coordinates
19LAND CONVERSION DOCUMENTS
20EDS REPLY LETTER-11-09-2019.pdf
21AREA CALCULATION WITH LAYOUT PLAN OF RETAIL OUTLET
22APPROVE LAYOUT PLAN OF RETAIL OUTLET
23MORTH PERMISSION