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/TG/ROAD/32342/2018   (ii). Name of Project for which Forest Land is required : 4 - Laning of NH- 363 HKC in Telangana.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Feasibility study and Preparation of Detailed Project Report for construction of four laning of NH 363 Hyderabad-Karimnagar-Chanda road from Km 0.000 (Km.251.900) to Km 94.602 (Km 342.000) (from Mancherial to Maharashtra State border) in the state of Telangana.162,   (iv). State : Telangana   (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) : 162000   (viii). Area of forest land proposed for diversion(in ha.): 62.25   (ix). Non-forest land required for this project(in ha.): 324.562   (x). Total period for which the forest land is proposed to be diverted(in years): 100
A-2. Details of User Agency
  (i). Name : National Highways Authority of India   (ii). Address1 : National Highwasy Authority of India, Project Implementation Unit, H.No, 1-2-21/k16/18, L.K. Towers2nd Floor, Shivaji Chowk, Nirmal, Nirmal District   (iii). Address2 : National High Wasy Authority of Inida, Project Implementation Unit, H.No, 1-2-21/k16/18, L.K. Towers, 2nd Floor, Shivaji Chowk, Nirmal, Nirmal District   (iv). State : Telangana   (v). District : Adilabad   (vi). Pin : 504106   (vii). Landmark : L.K.Towers   (viii). Email address : nirmal@nhai.org   (ix). Landline Telephone No. : 8734-4241365   (x). Fax No. : 8734-   (xi). Mobile No. : 8008987999   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: MIR   (ii). Middle Name: HAMED   (iii). Last Name: ALI   (iv). Gender: Male   (v). Designation: DGM   (vi). Address 1: National Highways Authority of India, Project Implementation Unit, H.No, 1-2-21/k16/18, L.K. Towers, 2nd Floor, Shivaji Chowk, Nirmal, Nirmal District   (vii). Address 2: NIL   (viii). State: Telangana   (ix). District: Adilabad   (x). Tehsil: Nirmal   (xi). Pin: 504106   (xii). Landmark: L.K.Towers   (xiii). Email Address: nirmal@nhai.org   (xiv). Landline Telephone No.: 873-4241365   (xv). Fax No.: NIL   (xvi). Mobile No.: 8008987999   (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.Mancherial42.5793.097
2.Bellampally3.5583.431
3.Asifabad16.13148.034
Total62.25324.562
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Mancherial46.12176.528
1.Komarambheem Asifabad16.13148.034
Total62.25324.562
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Ramarao pet15.9860
2Singapur6.0722.705
3Tallapalli09.051
4Naspur14.8355.401
5Mancherial016.576
6Garmilla06.578
7Thimmapur5.6554.219
8Andgulapeta04.058
9Mandamarri018.201
10Kasipet00.072
11peddampalli014.23
12Akenipalli08.403
13Boypalli04.76
14Kannal039.341
15Kistampet02.002
16Tandur08.14
17Kottapalli3.395.991
18Pagadipalli0.2620.492
19Pultikunat0.5457.333
20Repalle wada05.893
21Gangapur2.8670.927
22Rebbana09.448
23Nerpalli09.004
24Edavelly05.516
25kondapalle02.556
26Khairgaon06.667
27Motuguda03.772
28Buruguda04.566
29Asifabad08.571
30Godavalle03.042
31Rajampet06.887
32Janakpur027.78
33Saleguda02.55
34Ippalnvegaon06.15
35Jaithpur04.623
36Bendra011.491
37Tajapur00.749
38Sarandi04.536
39Wankidikalan011.447
40Bambara3.7483.767
41Mahagaon3.9630.442
42Govegaon4.920.32
Total 62.243 298.257
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road62.25324.562
Total 62.25 324.562
C. Maps of forest land proposed to be diverted
Division 1. : Asifabad
  (i). Area of forest land proposed to be diverted(in ha.) : 16.13   (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).
1.16.13    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:
Division 2. : Mancherial
  (i). Area of forest land proposed to be diverted(in ha.) : 42.57   (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).
1.42.57    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:
Division 3. : Bellampally
  (i). Area of forest land proposed to be diverted(in ha.) : 3.55   (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).
1.3.55    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 only Up-gradation of the existing road to fou
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): 50000
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?: Yes   (a). Copy of Cost-Benefit analysis:
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? : No
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
1Index Map of the project road
2Topo sheet NO - E 44 B6
3MoEF and CC notification for exemption of EC
4Topo Sheet No. E44B7
5Topo Sheet No. E44B8
6MANCHERIAL 3A
7MANCHERIAL 3A 2
8ASIFABAD 3A
9ASIFABAD 3A 2
10TOPO SHEET E44H5
11TOPO SHEET E44H9
12Typical Cross Sections
13Project Description
14Geo-referenced map f the project location
15MoEF circular exempting grama sabha
16Undertaking for additional NPV
17Undertaking for any other condition
18Archaeological certificate from UA
19Bare minimum certificate from UA
20checklist
21undertaking to pay NPV
22undertaking for paying CA land from UA
23undertaking for environmental clearance from UA
24FORM A
25FRA Undertaking
26Project justification
27certificate for no alternatives for project from UA
28undertaking for No Labour Camp
29certificate for No violation of FCA
30undertaking for demarcation of stones from UA
31undertaking for unqualified commitment from UA
32undertaking for work in non forest land from UA
33project brief note
34Cost benefit analysis
35Revised Form-A
36Undertakings revised
37CBA revised