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/43668/2019
(ii). Name of Project for which Forest Land is required :
Construction of Approach Road for Hindustan Petroleum Corporation Ltd. Retail Outlet on Jaisalmer - Barmer Road (NH-68) Between KM Stone No. 95-96 (Chainage: 95/612 to 95/662) RHS in the Part of Khasra No. 1486/534 At Village-Gunga, Tehsil-Sheo, District-Barmer, Raj.
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
Construction of Approach Road for Hindustan Petroleum Corporation Ltd. Retail Outlet on Jaisalmer - Barmer Road (NH-68) Between KM Stone No. 95-96 (Chainage: 95/612 to 95/662) RHS in the Part of Khasra No. 1486/534 At Village-Gunga, Tehsil-Sheo, District-Barmer, Raj.
(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.):
0.1788
(ix). Non-forest land required for this project(in ha.):
0.2412
(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 :
HINDUSTAN PETROLEUM CORPORATION LTD JODHPUR
(ii). Address1 :
HPCL JODHPUR
(iii). Address2 :
Retail Regional Office, Jodhpur
(iv). State :
Rajasthan
(v). District :
Jodhpur
(vi). Pin :
342005
(vii). Landmark :
NIL
(viii). Email address :
hpclgudiya@gmail.com
(ix). Landline Telephone No. :
2931-2989210
(x). Fax No. :
2931-
(xi). Mobile No. :
9414747664
(xii). Website (if any) :
NIL
(xiii). Legal status of User Agency :
Central PSU
A-3.
Details of Person Making Application
(i). First Name:
Shri
(ii). Middle Name:
Krishan
(iii). Last Name:
Lal
(iv). Gender:
Male
(v). Designation:
DGM Retail
(vi). Address 1:
Retail Regional Office, Jodhpur
(vii). Address 2:
NIL
(viii). State:
Rajasthan
(ix). District:
Jodhpur
(x). Tehsil:
NIL
(xi). Pin:
342005
(xii). Landmark:
NIL
(xiii). Email Address:
hpclfcagunga@gmail.com
(xiv). Landline Telephone No.:
2931-2989210
(xv). Fax No.:
NIL
(xvi). Mobile No.:
9860135672
(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
1
Approved
FP/RJ/ROAD/15815/2015
F.1(31)Forest/2016
0.0979
0.0979
26 Sep 2016
10 Feb 2017
Total
0.0979
0.0979
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.
Barmer Territorial
0.1788
0.2412
Total
0.1788
0.2412
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Barmer
0.1788
0.2412
Total
0.1788
0.2412
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
Gunga
0.1788
0.2412
Total
0.1788
0.2412
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Outlet Area
0
0.2
2
Construction of Approach Road DecelerationLane LHS
0.0553
0.0206
3
Construction of Approach Road AccelerationLane RHS
0.0775
0.0206
4
Front Side Service Road
0.045999
0
Total
0.178799
0.2412
C.
Maps of forest land proposed to be diverted
Division 1. : Barmer Territorial
(i). Area of forest land proposed to be diverted(in ha.) :
0.1788
(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.
0.0553
View File
2.
0.0775
View File
3.
0.046
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 RoW is 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):
9
(iii). Temporary Employment(Number of person-days):
250
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
LoI Copy.
2
Dealership Allotment Documents..
3
Land Conversion Letter.
4
MoRTH NoC.
5
Khasra Map and Jamabandi Nakal.
6
CERTIFICATE FOR MINIMUM USE OF FOREST LAND.
7
DETAILS OF PERMANENT EMPLOYMENT TO BE GENERATED.
8
UNDERTAKING FOR CONSERVATION OF FLORA FAUNA DURING CONSTRUCTION OF ROAD.
9
UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED.
10
UNDERTAKING FOR NO OTHER FEASIBLE ATTERNATIVE AND DIVERSION OF MINIMUM FOREST LAND.
11
UNDERTAKING FOR PAYMENT OF ANY OTHER COST AND CONDITIONS.
12
UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION.
13
UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST LAND PROPOSED FOR DIVERSION.
14
UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST LAND.
15
UNDERTAKING FOR USE OF FOREST LAND.
16
UNDERTAKING FOR WASTE MANAGEMENT DURING CONSTRUCTION OF ROAD>
17
Approved Layout Plan.
18
Bar Chart Status.
19
Digital map.
20
Full Toposheet Map 40N4.
21
Layout Plan with Area Calculation.
22
SOI Toposheet Map 50000 Scale.
23
Area Calculation Sheet.
24
Reply of 25.02.2020 EDS letter.
25
Project Report.
26
Consent Letter of Land Owner.
27
Reply Letter of 25.08.2020 EDS.
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