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/ROAD/53276/2020   (ii). Name of Project for which Forest Land is required : Construction of 6 lane Highway, Greenfield corridor from Chittoor – Thatchur road (NH 716B)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of 6 lane Highway, Greenfield corridor from Chittoor – Thatchur road (NH 716B)   (iv). State : Tamil Nadu   (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) : 384000   (viii). Area of forest land proposed for diversion(in ha.): 14.029   (ix). Non-forest land required for this project(in ha.): 294.7696   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : National Highways Authority of India   (ii). Address1 : National Highways Authority of India, "Sri Towers" 3rd floor, DP 34 (SP) Industrial Estate, Guindy Chennai   (iii). Address2 : NIL   (iv). State : Tamil Nadu   (v). District : Chennai   (vi). Pin : 600032   (vii). Landmark : Sri Towers   (viii). Email address : kancheepurampiu@gmail.com   (ix). Landline Telephone No. : 44-22251885   (x). Fax No. : 44-   (xi). Mobile No. : 9444476854   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: P   (ii). Middle Name: T   (iii). Last Name: Mohan   (iv). Gender: Male   (v). Designation: PD   (vi). Address 1: National Highways Authority of India, Sri Towers 3rd Floor, DP 34 SP Industrial Estate, Guindy, Chennai   (vii). Address 2: NIL   (viii). State: Tamil Nadu   (ix). District: Chennai   (x). Tehsil: Mambalam Guindy   (xi). Pin: 600032   (xii). Landmark: Sri Towers   (xiii). Email Address: kancheepurampiu@gmail.com   (xiv). Landline Telephone No.: 44-22251885   (xv). Fax No.: NIL   (xvi). Mobile No.: 9444476854   (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.Tiruvallur14.029294.7696
Total14.029294.7696
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Tiruvallur14.029294.7696
Total14.029294.7696
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Venkatarajakuppam024.033
2Thirumalrajpettai3.41866.1181
3Kumarajapettai014.275
4Perumanallur016.3989
5Mallpudi012.9965
6Kellpudi3.17639.5512
7Samanthawada5.468518.2913
8Puniyam1.96568.5386
9Sennakesavapuram01.6484
10Pennaluripet09.4503
11Puducheri014.0944
12Pondavakkam018.1624
13Peruttivakkam05.4612
14Mambakkam010.1299
15Vadathillai04.0736
16Tharakshi00.7671
17Perandur Bit I010.4109
18Panapakkam014.1
19Sennankaranai010.7634
20Tholavedu019.2809
21Paruttimenikuppam04.4791
22Sengathakulam017.6143
23Vadamadurai016.2461
24Alappakkam07.6308
25Athivakkam02.0251
26Kannigaipair016.706
27Krishnapuram Kandigai01.0806
Total 14.029 294.3271
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Carriageway4.9954127.1969
2Shoulders1.069624.5233
3Drain0.26925.5122
4ROW7.6948137.5372
Total 14.029 294.7696
C. Maps of forest land proposed to be diverted
Division 1. : Tiruvallur
  (i). Area of forest land proposed to be diverted(in ha.) : 14.029   (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).
1.14.029    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: Yes   (a). Copy of map indicating location of alternative examined:
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 100   (iii). Temporary Employment(Number of person-days): 2000
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 ? : Yes   (a). Status of the Environmental Clearance to the Project: EC under process   (ii). Environmental Clearance File No.: 10-49/2018-IA.III
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
1Certificate for no Violation of Forest Act
2Certificate Of User Agency For Use of Fly ASH
3Document Verification
4No Objection from Gram Sabha
5Note On Project
6Project Traffic Details
7Undertaking for Cost Benefit Analysis
8Undertaking for the Cost of Felling of Trees
9Undertaking for the Payment of Compensatory
10Undertaking for the Payment of Rent or Lease for the Forest Area
11Undertaking for Unqulified Commitment
12Undertaking of the Payment of NPV
13Undertaking of the Additional Cost
14Villagewise land details
15GPS Coordinates
16Reply of PCCF Letter
17Forest Area Statement
18SOI Maps
19DGPS Coordinates
20Certificate for Minimum Forest land
21TCS
22Status of Environment Clerance
23Survey numberwise detail
24GPS of Proposed Forest
25Reply of PCCF Letter dated 22-02-2021
26Letter of DC for Non-availability of Forest land
27EC and CRZ Clearance Status
28Structure details
29Intimation of Competion of DGPS Survey
30
31Compliance report of UA on SG