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/11483/2015   (ii). Name of Project for which Forest Land is required : Panjitilani to Sainj MR   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : This road will provide connectivity to Khamrauli, Dilau and Sainj villages with main road.   (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) : 111.2   (viii). Area of forest land proposed for diversion(in ha.): 0.9975   (ix). Non-forest land required for this project(in ha.): 1.8025   (x). Total period for which the forest land is proposed to be diverted(in years): NIL
A-2. Details of User Agency
  (i). Name : PUBLIC WORKS DEPARTMENT   (ii). Address1 : Executive Engineer,ty.division,PWD,Sahiya Dehradun   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Dehradun   (vi). Pin : 248196   (vii). Landmark : civil land   (viii). Email address : eepwdsahiyakalsi@gmail.com   (ix). Landline Telephone No. : 1360-274595   (x). Fax No. : 1360-1360   (xi). Mobile No. : 9456745631   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: S   (ii). Middle Name: K   (iii). Last Name: Tyagi   (iv). Gender: Male   (v). Designation: Assistant Engineer   (vi). Address 1: O/0 E.E., Ty.Div.,PWD, Sahiya   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Dehradun   (x). Tehsil: Dehradun   (xi). Pin: 248196   (xii). Landmark: civil land   (xiii). Email Address: eepwdsahiyakalsi@gmail.com   (xiv). Landline Telephone No.: 1360-274595   (xv). Fax No.: 1360274595   (xvi). Mobile No.: 9412917304   (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.Chakrata0.99751.8025
Total0.99751.8025
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Dehradun0.99751.8025
Total0.99751.8025
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Panjitilani, Saij, dilau0.99751.8025
Total 0.9975 1.8025
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road0.99751.8025
Total 0.9975 1.8025
C. Maps of forest land proposed to be diverted
Division 1. : Chakrata
  (i). Area of forest land proposed to be diverted(in ha.) : 0.9975   (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).
1.0.9975    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): 2   (iii). Temporary Employment(Number of person-days): 20
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
1Form A pt 1 to 5
2Administrative and financial sanction
3Joint ispection
4Land schedule
5Bar chart
6Alternative alingment certificate
7Arial distance of National Park
8Benefited villages
9Comperision of alingment
10Geologist report
11No alternative land availability certi
12SIR
13Standard condition
14Task force
15tree details
16less tree effected
17No wilde animal effected
18Chief wilde life certificate
19Relegious historical place
20Effected tree details
21100 tree plantation scheme
22Khasra Details
23Undertaking of LPG
24Whether a part or not of any National park or wildelife
25Cert reg Flora and fauna
26Certi reg Oak trees
27Ownership certi
28Prativedan
29NOC of Gram Panchyat
30Undertaking reg geologist rep
31Check list
32Comperision of alingment and Muck disposal plan
33Comperision of alingment and Muck disposal plan
34Reference latter
35Alingment
36Muck disposal Plan
37As per your Latter No. 52/127 Dated- 06.07.2016 Comperision of alingment and Muck disposal plan