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/TN/Others/36436/2018   (ii). Name of Project for which Forest Land is required : Laying of OFC along road side of Samudram to Kulathur road section in Kallakurichi - Thiruvannamalai (SH-6) Road across Kaduvanur R.F. and Kanangadu R.F.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Laying of OFC line in road passing between from Kulathur to Rayasamudram via Kaduvanur, Pudhur villages across Kaduvanur R.F. and Kanangadu R.F. in Sankarapuram Taluk in Villupuram District.   (iv). State : Tamil Nadu   (v). Category of the Proposal : Others   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 0.15   (viii). Area of forest land proposed for diversion(in ha.): 0.0825   (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 : Jio Digital Fibre Private Limited   (ii). Address1 : No.89 Dr Radhakrishnan Salai Mylapore Chennai 4   (iii). Address2 : NIL   (iv). State : Tamil Nadu   (v). District : Chennai   (vi). Pin : 600004   (vii). Landmark : RK Salai   (viii). Email address : balsamy.thirunagalingam@ril.com   (ix). Landline Telephone No. : 44-40232575   (x). Fax No. : 44-43320725   (xi). Mobile No. : 9840419817   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: TT balsamy   (ii). Middle Name: NIL   (iii). Last Name: thirunagalingam   (iv). Gender: Male   (v). Designation: State_Coordinate_Officer   (vi). Address 1: No 89 Dr Radhakrishnan Salai Mylapore Chennai 4   (vii). Address 2: NIL   (viii). State: Tamil Nadu   (ix). District: Chennai   (x). Tehsil: Mylapore Triplicane   (xi). Pin: 600004   (xii). Landmark: RK Salai   (xiii). Email Address: balsamy.thirunagalingam@ril.com   (xiv). Landline Telephone No.: 44-40232575   (xv). Fax No.: 04443320725   (xvi). Mobile No.: 7010209251   (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.Villupuram0.08250
Total0.08250
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Viluppuram0.08250
Total0.08250
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Kulathur0.03870
2Pudhur0.04380
Total 0.0825 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Linear (Kulathur)0.03870
2Linear (Pudhur)0.04380
Total 0.0825 0
C. Maps of forest land proposed to be diverted
Division 1. : Villupuram
  (i). Area of forest land proposed to be diverted(in ha.) : 0.0825   (ii). Nature of the Project: Linear   (b). No. of Segments : Two
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).
1.0.0387    View File
2.0.0438    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: NIL
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 10   (iii). Temporary Employment(Number of person-days): 3000
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
1Location in Google Earth
2Route map from Villupuram City for easy approach the spot
3Area requirement details for the project
4Form A - abstract regarding project
5NPV certificate
6NPV regarding
7No other alternative other than this route
8No catchment treatment plan is under progress
9Minimum land requirement
10Barest minimum land
11Additional NPV
12agree to pay the cost of tree cutting if any
13Lease rent regarding
14Cost of compensatory land
15Form A Part I
16Reply letter to PCCF
17collector certificate for non availability other land
18Reply to PCCF letter
19Certificate regarding collector noc
20Less than one ha exempted for Compensatory afforestation As per 13 June 2023 Guide line
21reply letter to Letter from DFO C.No.6063/ 2022/ D. dated 4.1O.2O24