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/11434/2015   (ii). Name of Project for which Forest Land is required : Construction of Banlekh Maudiyar Gwatoli Motor road (12.00 km) under SCP   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of Banlekh Maudiyar Gwatoli Motor road (12.00 km) Under SCP starting from Km 33 of BDDK Motor Road. Connecting Villages Lasni, Horali, Maudiyar, Sundil, Junayal & Gwatoli in Teshsil-Kapkot, District-Bageshwar   (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) : 441   (viii). Area of forest land proposed for diversion(in ha.): 4.41   (ix). Non-forest land required for this project(in ha.): 3.99   (x). Total period for which the forest land is proposed to be diverted(in years): 100
A-2. Details of User Agency
  (i). Name : PWDKAPKOT   (ii). Address1 : C.D.P.W.D.KAPKOTE   (iii). Address2 : BAGESHWAR   (iv). State : Uttarakhand   (v). District : Bageshwar   (vi). Pin : 263642   (vii). Landmark : Kapkot   (viii). Email address : cdpwdkapkot@gmail.com   (ix). Landline Telephone No. : 5963-253385   (x). Fax No. : 5963-253385   (xi). Mobile No. : 9639377012   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Sanjay Kumar Pandey   (ii). Middle Name: Kumar   (iii). Last Name: Pandey   (iv). Gender: Male   (v). Designation: E.E.   (vi). Address 1: C.D.P.W.D.KAPKOTE   (vii). Address 2: BAGESHWAR   (viii). State: Uttarakhand   (ix). District: Bageshwar   (x). Tehsil: Kapkot   (xi). Pin: 263642   (xii). Landmark: kapkot   (xiii). Email Address: cdpwdkapkot@gmail.com   (xiv). Landline Telephone No.: 5963-253385   (xv). Fax No.: 05963253385   (xvi). Mobile No.: 9719471059   (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.Bageshwar4.413.99
Total4.413.99
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bageshwar4.413.99
Total4.413.99
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Maudiyar2.41.5
2Gwatoli2.012.49
Total 4.41 3.99
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Muck disposal (Nap Land)00.245
2Road4.410
3Nap Land03.745
Total 4.41 3.99
C. Maps of forest land proposed to be diverted
Division 1. : Bageshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 4.41   (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).
1.4.41    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: Other alternative alignment involves more trees an
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): 13500
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. : Bageshwar
  (a). Village: Karmi Civil Soyam   (b). Area(in ha.): 8.82   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 319   (e). Present owner: User Agency   (f). Copy of Ownership proof:
  (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
11.6.1
2A 2.2
3A 2.3
4A 2.4
5A 2.4.1
6A 2.7
7A 2.8
8A 2.10
9A 2.11
10A 2.13
11A 2.16
12A 2.19
13A 2.19.1
14A 2.20
15A 2.23
16A 2.24
17A 2.27
18A 2.28
19A 2.29
20A 2.30
21A 2.32
22A 2.33
23A 2.35
24A 2.36
25A 2.43
26other
27NoC of Van Panchayat
28A short narrative and importance of the project..
29Go road
30Copy of Mou/agreement executed between the Present owner and
31Details of the trees with their scientific name in RF, Civil Soyam,Van Panchayat, Private Notified land and in Nap Land should be mentioned (with valuation of the trees to be felled ) (0-10 dia trees
32Land schedule (for RF signed by DFO and civil soyam, Van panchayat and private nap land signed by DM)
33Category wise (RF,civil soyam, Van panchayat and private nap land,Notified forest land etc.) land length, width and area in Ha
34Certificate reg. suitability of indentified land for Comensatory(C.A)
35Geologist Report (Govt. approved Geologist
36Felling of Oak trees
37Certificate by DM- Forest right act 2006 reg.(in MoEF revis
38estimate 10 year plantains
39NOC from local Gram Sabhas
40Approved general lay out plan/alignment and estimate from
41Scanned copy of the Georeferenced map of the forest land
42Scanned copy of the Georeferenced map of the forest land
43obj remove copy
44EDS Dated 15-06-2016
45Muck disposal plan(Nap Land)
46EDS Dated 09-02-2017
47EDS Dated 20-04-2017
48Eds 21-06-2017
49eds dated 18-08-207
50CA CETFICAAT NEW
51Eds Dated 05-12-2017
52Eds Dated 22-11-2017
53Eds 22-11-2017
54EDS reply dated 22-11-2017
55Form A Part-III
56Form A Part-IV
57Form A Part-V
58FRA 2006
59Form A part 1