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/ROAD/11258/2015   (ii). Name of Project for which Forest Land is required : Dheghat - Nagchula To Chanterkhali -Kaliyalingudh Jhipa Bend Motor Road.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : By the Construction of Dheghat - Nagchula To Chanterkhali -Kaliyalingudh Jhipa Bend Motor Road (2.50 km.). Villagers related these portion will got benefit therefore construction of above mentioned road is important for effected villagers   (iv). State : Uttarakhand   (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) : 31.5   (viii). Area of forest land proposed for diversion(in ha.): 1.485   (ix). Non-forest land required for this project(in ha.): 0.765   (x). Total period for which the forest land is proposed to be diverted(in years): 300
A-2. Details of User Agency
  (i). Name : EXECUTIVE ENGINEER   (ii). Address1 : Provincial Division P.W.D., Ranikhet   (iii). Address2 : Mall Raod Ranikhet   (iv). State : Uttarakhand   (v). District : Almora   (vi). Pin : 263645   (vii). Landmark : NIL   (viii). Email address : eepdrani@yahoo.com   (ix). Landline Telephone No. : 5966-220679   (x). Fax No. : NIL   (xi). Mobile No. : 7500540231   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Lalit   (ii). Middle Name: Kumar   (iii). Last Name: Goel   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Provincial Division PWD, Ranikhet   (vii). Address 2: Mall Road Ranikhet   (viii). State: Uttarakhand   (ix). District: Almora   (x). Tehsil: NIL   (xi). Pin: 263645   (xii). Landmark: Ranikhet   (xiii). Email Address: eepdrani@yahoo.com   (xiv). Landline Telephone No.: 5966-220679   (xv). Fax No.: 05966220679   (xvi). Mobile No.: 9412919971   (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
1ApprovedFP/UK/ROAD/19725/20168B/UCP/06/173/2016/FC/19532.162.1629 Dec 201621 Feb 2018
Total 2.16 2.16
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.Almora1.4850.765
Total1.4850.765
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Almora1.4850.765
Total1.4850.765
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Kalyaligun1.440.765
2Chantarkani0.0450
Total 1.485 0.765
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road 0 to 2.251.4850.645
2Muck Disposal Yard00.12
Total 1.485 0.765
C. Maps of forest land proposed to be diverted
Division 1. : Almora
  (i). Area of forest land proposed to be diverted(in ha.) : 1.485   (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).
1.1.485    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): 15   (iii). Temporary Employment(Number of person-days): 100
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. : Almora
  (a). Village: Kalyaligur   (b). Area(in ha.): 3   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 38/52   (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:   (vi). Copy of Survey of India Toposheet in 1:50,000 scale indicating location of the land identified for creation of Compensatory Afforestation:
Additional information Details
Documents
S.No Documents
Remarks
1A Short Narrative and Importance of the Project
2Administrative and Financial Sanction
3Preliminary Joint Inspection Report
4Comperative chart showing statement of both alignment or alternate site
5Certificate from the DM that no alternative suitable non-forest land
6Land schedule
7Category wise land length
8Bar Chart With Index
9Compensatory afforestation scheme in Civil and Soyam land (10years)
10Certificate Regarding suitability of indentified hand for CA
11Undertaking by the user agency to bear the cost of CA
12Road Side/Gap Filling Plantation Estimate
13Undertaking by the User Agency to bear the cost of Road Side/Gap Filling Plantation
14Details of the trees with their scientific name in RF, Civil Soyam, Van panchayat, Private Notified land
15Felling of Oak trees (If involves, inspection report of the concerning CF has to be provided)
16Certificate of felling minimum trees during the project work.
17Muck disposal scheme
18Whather project area is a part of National Park or sanctuary and airal distance of the project from National Park or sanctuary signed by DFO
19No voilation has taken place, FC Act. 1980 reg.
20NOC from local Gram Sabhas
21Certificate work has not been started reg.
22Geologist Report
23Task Force Report
24Item wise details of works
25Certificate by user agency for complying the condition imposed in Manak Shartain
26Certificate by user agency for complying the condition imposed in geologist report/Task forcex
27historical/monumental or relegeous place will be effected certificate reg.
28Undertaking regarding no animal will be effected adversely by the project
29Undertading to provide alternative fuel wood, kerosene or LPG to labours
30Benefited villagers/families/population certificate
31Undertaking of payment of NPV S. court increases the rates of NPV
32Cost of the forest land and lease rent certificate
33Undertaking of user agency to bear the cost for dimarcation work
34Check list/Fact Sheet
35Hard copy receiving letter in ref of your objection raised on 10-06-2016
36Objection removal by letter no 2257/36c dated 22-10-16 in ref of your letter no memo/12-1(2) dated 14-09-2016