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/UK/DISP/114282/2020   (ii). Name of Project for which Forest Land is required : Construction of State Cancer Institute by upgrading of existing Swami Ram Cancer Hospital at Haldwani   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Swami Ram Cancer Hospital Haldwani is catering Cancer treatment to the population of Uttarakhand and nearby States since 12 years. Government of India is sponsoring funds to upgrade it as State Cancer Institute. Beside it a 200 bedded Infection Disease Hospital (i.e. Covid-19 Pandemic) is proposed.   (iv). State : Uttarakhand   (v). Category of the Proposal : Dispensary/Hospital   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 8888.75   (viii). Area of forest land proposed for diversion(in ha.): 4.25   (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 : GOVERNMENT MEDICAL COLLEGE HALDWANI   (ii). Address1 : Rampur Road, Haldwani   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Nainital   (vi). Pin : 263139   (vii). Landmark : NIL   (viii). Email address : principal.gmchld@rediffmail.com   (ix). Landline Telephone No. : 5946-282824   (x). Fax No. : NIL   (xi). Mobile No. : 9997533664   (xii). Website (if any) : www.gmchld.org   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Dr R   (ii). Middle Name: C   (iii). Last Name: Purohit   (iv). Gender: Male   (v). Designation: Principal   (vi). Address 1: Government Medical College,Rampur Road, Haldwani   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Nainital   (x). Tehsil: NIL   (xi). Pin: 263139   (xii). Landmark: NIL   (xiii). Email Address: principal.gmchld@rediffmail.com   (xiv). Landline Telephone No.: 5946-282824   (xv). Fax No.: 05946282578   (xvi). Mobile No.: 9412410759   (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
1Under Processing at State GovernmentFP/UK/DISP/6879/201415.8920
Total 15.892 0
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.Tarai Central,Haldwani4.250
Total4.250
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Nainital4.250
Total4.250
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Haldwani Khas4.250
Total 4.25 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Patch-2 New R.T. Block0.1250
2Patch1- Nuclear Medicine Lab, Radiodiagnosis and L2.5150
Total 2.64 0
C. Maps of forest land proposed to be diverted
Division 1. : Tarai Central,Haldwani
  (i). Area of forest land proposed to be diverted(in ha.) : 4.25   (ii). Nature of the Project: Non Linear   (a). No. of patches : Two
Patch wise details
Patch No. Area of Patch(in ha.) Kml File of PatchesTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0.44    View File
2.2.671    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:
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 156   (iii). Temporary Employment(Number of person-days): 1000
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?: Yes   (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 ?: No   (iii). No. of districts involved for raising Compensatory Afforestation: 1   (iv). No. of patches: One
District 1. : Pithoragarh
  (a). Village: Ramtoli   (b). Area(in ha.): 5.28   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 2288   (e). Present owner: Others   (f). Copy of ownership proof:   (g). Copy of Mou/agreement executed between the Present owner and the User Agency:   (h). Copy of non encumberence certificate for the forest land:
  (v). Scanned copy of the map of the land identified for creation of Compensatory Afforestation prepared by using GPS ot Total Station: No Data   (vi). Copy of Survey of India Toposheet in 1:50,000 scale indicating location of the land identified for creation of Compensatory Afforestation: No Data
Additional information Details
Documents
S.No Documents
Remarks
1Cover Page
2Check List/Fact Sheet
3Index
4Form 1- Short narrative of the Project
5Form 3-Administrative and Financial Approval
6Form 4- Joint Inspection Report
7Form 5- Site Inspection Report of DFO
8Form 8- Cancelation of alternative alignment
9Form-9 - Comparative description of various option in land
10Form-10 - No other alternate is and requirement of minimum land
11Form-11 Land schedule (Forest Deptt)
12Form-11 A Land schedule (Revenue Deptt)
13Form-12 - Length and width of the land
14Form-13 - Bar chart of the land
15Form-14 - Certification for new construction not started
16Form-16- Site inspection report of Baanj Tree on proposed land
17Form-17- Minimum tree fallen certificate
18Form-18- Certification for not a part of National park or wildlife centaury
19Form-19- Certification for distance from National park or wildlife centaury
20Form-20- Certificate (Not required due to proposed land distance is more than 10 k.m. from National park/wildlife centaury)
21Form-21- NOC from general meeting of ward-53
22Form-23- NOC from SMD level committee, DM level committee
23Form-23- NOC from Ward and Nagar Nigam committee
24FRA Certificate
25Form-26- Geological report
26Form-27- Task Force Certificate
27Form- 28 - Task force recommendation
28Form- 29 - Manak terms acceptable
29Form- 30 - No holy place
30Form- 31 - No harm to animals
31Form- 33 - Benefit to population
32Form- 34 - Lease rent certificate
33Form- 35 - CA estimate
34Form- 36 - Appropriate land for CA
35Form- 37 - Plantation estimate in blank spaces
36Form- 38 - Plantation amount deposit certificate
37Form- 39 - CA amount deposit certificate
38Form- 42 - NPV amount calculation
39Form- 43 - NPV amount deposit certificate
40Form- 44 - RCC pillar estimate
41Form- 46 - Non violation certificate
42Civil Land provided by DM Pithoragarh for CA provided by DM Pithoragarh
43Reply of GoI query dated 26-02-2021 of letter no. 8B/UCP/09/21/2021/FC/2373
44Reply of Nodal Queries dated 12-04-2021
45CA Scheme Authenticated by DFO
46Letter regarding Muck Disposal Scheme Not Required.
47Reply of query raised by GoI dated 31-08-2021
48Reply of quay dated 15.12.2021. Revised layout required only 3.111 ha. forest land while exclusion of future construction as per instruction given by R.O. Forest Land, Dehradun.
49orm 6- Toposheet Map of 3.111 H Forest Land
50Form 7- Geo Reference Map of 3.111 H Forest Land
51Google Map (Revised) 3.111 H Forest Land
52Reply of query raised by Nodal Office vide letter no 79/FP/UK/DISP/114282/2020 dated 07.07.2022 and MoEF letter no 8B/UCP/09/21/2021/FC/1192 dated 15.12.2021
53Reply of Query raised by Nodal Office vide letter no-1099/FC/UK/DISP/114282/2020 dated 21-10-2022
54As per direction of RO, revised plan is being uploaded herewith.
55As per direction of RO, revised Layout plan of 2.64 hectare required Forest Land is being uploaded herewith.
56Revised CA Estimate
57Revised Estimate of RCC Piller
58Revised list of affected tree
59Revised google map of CA land
60Revised google map of required forest land
61Tree counited in proposed land and its estimate.
62Reply of GoI query dated 09-05-2023 of letter no. 8B/UCP/09/21/2021/FC/146.
63Revised layout Plan and buildings maps.