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/33453/2018   (ii). Name of Project for which Forest Land is required : Chakrata kalsi OFC kalsi -lohari   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Laying of Optical Fibre Cable (OFC) along with road at Hill Side on NH-123(New-507) (Herbertpur-Nainbagh road) SH-20 (Kalsi-Makhti Road) NH- 707A (Chakrata-Lohari Road) Total km. 94.00 &0.9486 Ha.   (iv). State : Uttarakhand   (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) : 564   (viii). Area of forest land proposed for diversion(in ha.): 0.68   (ix). Non-forest land required for this project(in ha.): 0.26   (x). Total period for which the forest land is proposed to be diverted(in years): 30
A-2. Details of User Agency
  (i). Name : RELIANCE JIO   (ii). Address1 : Plot no 32, IT Park   (iii). Address2 : sahastradhara road dehradun   (iv). State : Uttarakhand   (v). District : Dehradun   (vi). Pin : 248001   (vii). Landmark : IT park   (viii). Email address : tarit.mohan@ril.com   (ix). Landline Telephone No. : 135-6134219   (x). Fax No. : 135-   (xi). Mobile No. : 9149361424   (xii). Website (if any) : www.jio.com   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Deepak   (ii). Middle Name: Pal   (iii). Last Name: Singh   (iv). Gender: Male   (v). Designation: SCO   (vi). Address 1: Reliance Megamart, GMS Road, Dehradun   (vii). Address 2: uttrakhand   (viii). State: Uttarakhand   (ix). District: Dehradun   (x). Tehsil: NIL   (xi). Pin: 248001   (xii). Landmark: Near Kamla Palace Hotel   (xiii). Email Address: pankaj35.singh@ril.com   (xiv). Landline Telephone No.: 941-2056330   (xv). Fax No.: NIL   (xvi). Mobile No.: 9781535435   (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.Chakrata0.680.26
Total0.680.26
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Dehradun0.680.26
Total0.680.26
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Kalsi0.1580
2Harbatpur0.1460
3Nainbagh0.1590
4waadwala0.0250
5pata0.1430
6sahiya0.1630
7Lohari0.0220
8Chakrata0.0010
9daakpatthar0.0070
10Vikasnagar0.0220
11Juddo0.0060
12Yamuna pul0.0250
13Labhwar Bend0.0090
14Aloo Mandi0.010
15Bhangar- Thana0.0050
Total 0.901 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1laying of optical fibre0.680.26
Total 0.68 0.26
C. Maps of forest land proposed to be diverted
Division 1. : Chakrata
  (i). Area of forest land proposed to be diverted(in ha.) : 0.68   (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).
1.0.68    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: No alternative available only permitted route appl
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 30   (iii). Temporary Employment(Number of person-days): 90
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
1Guideline for exemption of NPV
2Power of Attorney for authorized signatory
3License for IP operations to reliance Jio
4Name change certificate for RJIL
5PWD permission Chakrata to lohari
6PWD permission Herbertpur to Nainbagh
7PWD permission kalsi to Makhti
8Area Calculatio sheet
9index of file
10Form l Prativedan
11Form 5 certificate of primary permission
12form 6 joint survey
13maps
14form 14 undertaking for no other alternatives
15form 15 land schedule
16form 16 area calculation
17form 17 bar chart
18form 18 - undertaking of work not started
19form 19 - no trees certificate
20form25 air distance from wildlife
21form 30 FRA
22form 25.2 not a specified site certificate
23form 33 no requirement of geological survey
24form 34- 35 task force certificate
25form 36 terms and conditions
26form 37 non religious site
27form 38 no affect on flora and fauna
28form 39 provision of fuel from govt licensed supply
29form 41 land value
30form 49 undertaking for no disposal of waste into the forest land
31form 51 NPV
32form 56 environment clearance
33fact sheet
34Please find the reply to EDS raised on 01/12/2018