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/Others/14556/2015   (ii). Name of Project for which Forest Land is required : Construction of Residential house at Srinagar Pvt. Notified Forest Estate Mussoorie   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : I have a piece of land measuring 0.41189 ha. at Srinagar Private Notified Forest Estate, Mussoorie, out of which in 0.024996 ha. land i want to construct a residential building for me and my family.   (iv). State : Uttarakhand   (v). Category of the Proposal : Others   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 79   (viii). Area of forest land proposed for diversion(in ha.): 0.024996   (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 : AMIT RAJENDRA KUMAR GUPTA   (ii). Address1 : Srinagar Estate, Kempty Road, Mussoorie.   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Dehradun   (vi). Pin : 248179   (vii). Landmark : NIL   (viii). Email address : htmpl@yahoo.com   (ix). Landline Telephone No. : 135-2620723   (x). Fax No. : 135-   (xi). Mobile No. : 9358300051   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Amit   (ii). Middle Name: Rajendra Kumar   (iii). Last Name: Gupta   (iv). Gender: Male   (v). Designation: Self Employeed   (vi). Address 1: Srinagar Estate, Kempty Road, Musso.orie   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Dehradun   (x). Tehsil: Dehradun   (xi). Pin: 248179   (xii). Landmark: NIL   (xiii). Email Address: htmpl@yahoo.com   (xiv). Landline Telephone No.: 135-2620726   (xv). Fax No.: NIL   (xvi). Mobile No.: 9358300051   (i). Copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency: No Data
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.Mussoorie0.0249960
Total0.0249960
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Dehradun0.0249960
Total0.0249960
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Srinagar Estate0.0249960
Total 0.024996 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Residential Building0.0249960
Total 0.024996 0
C. Maps of forest land proposed to be diverted
Division 1. : Mussoorie
  (i). Area of forest land proposed to be diverted(in ha.) : 0.024996   (ii). Nature of the Project: Non Linear   (a). No. of patches : One
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.
1.0.024996    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): 0   (iii). Temporary Employment(Number of person-days): 500
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? : 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
1Form A pt 1
2Joint Inspection Rep
3Land schedule
4MDDA lettert
5NOC from Nagarpalika
6Geologist Report
7Project report
8Shapath patra
9No alternative land
10No historical or religious palce
11No violation certificate
12Not a part of PA
13SIR by DFO
14Trees list
15Trees to felled
16Standard condition Manak shartain
17Cert reg NPV
18Estimate of 100 trees plantation
19work not started
20Certificate reg uploading proposal
21Boundary demarcation
22Form A pt 2
23Map
24Form A pt3
25Sale Deed
26Not involve in 1042 cases in RIT 749/95
27Cert reg Muck disposal
28Note of CF reg oak trees
29Distance from park or centuary
30Sapath patra page 1
31Sapath patra page 2
32Detail Itemwise breakup
33Prativedan reconsidration on proposal of residential building