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/121027/2021   (ii). Name of Project for which Forest Land is required : UP-gradation and 4-lanning of Paonta Saheb-Ballupur (Dehradun) Section of NH-72 (Km 104.00 to Km 149.00) in the state of Uttarakhand   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : UP-gradation and 4-lanning of Paonta Saheb-Ballupur (Dehradun) Section of NH-72 (Km 104.00 to Km 149.00) in the state of Uttarakhand   (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) : 80000   (viii). Area of forest land proposed for diversion(in ha.): 24.1884   (ix). Non-forest land required for this project(in ha.): 132.9616   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : NATIONAL HIGHWAY AUTHORITY OF INDIA, VASANT VIHAR, PIU, DEHRADUN   (ii). Address1 : House No 171, Phase 1, Vasant vihar, Dehradun   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Dehradun   (vi). Pin : 248001   (vii). Landmark : NIL   (viii). Email address : piuvasantvihar.forest@gmail.com   (ix). Landline Telephone No. : 0-   (x). Fax No. : 0-   (xi). Mobile No. : 7500209819   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: Pankaj   (ii). Middle Name: Kumar   (iii). Last Name: Mourya   (iv). Gender: Male   (v). Designation: GeneralManager   (vi). Address 1: Hosue No 171, Phase 1, Vasant vihar, Dehradun   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Dehradun   (x). Tehsil: Dehradun   (xi). Pin: 248001   (xii). Landmark: NIL   (xiii). Email Address: piuvasantvihar.forest@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 7500209819   (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.Soil Conservation,Kalsi24.1884132.9616
Total24.1884132.9616
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Dehradun24.1884132.9616
Total24.1884132.9616
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Kulhal Matak5.11251.554
2Matka Majri4.51.145
3Kunja2.71031.741
4Kunjagrant3.93941.9546
5Aduwala3.62321.152
6Shahpur Kalyanpur3.18111.556
7Dharmawala1.12191.689
8Prateetpur Kalyanpur05.075
9Badripur05.85
10Mednipur Badripur07.515
11Majri02.8
12Jatowala04.455
13Tiparpur03.85
14Shabhawala013.95
15Kalyanpur03.64
16Hasanpur010.17
17Sherpur07.35
18Shisambada010.115
19East Hope Town024.12
20Arcadia Grant05.04
21Mithi Behadi01.96
22Shahpur Santor07.38
23Panditwadi02.275
24Dhartawala Mafi01.845
25Bajawala01.98
26Kanwali02.8
Total 24.1884 132.9616
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road20.8707127.5028
2Bridge Section0.44735.4588
3Hill Cutting2.87040
4Muck Disposal Area00
Total 24.1884 132.9616
C. Maps of forest land proposed to be diverted
Division 1. : Soil Conservation,Kalsi
  (i). Area of forest land proposed to be diverted(in ha.) : 24.1884   (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).
1.24.1884    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): 0   (iii). Temporary Employment(Number of person-days): 187200
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?: Yes   (a). Copy of Cost-Benefit analysis:
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
1MoM NHAI.
2EDS Reply Letter Dated 05_03_2021 with Annexures.
3EDS Reply Compliance Letter Dated 21_06_2021.
4Compliance Report of EDS raised by Letter no 572_12 dated 27_08_2021.
5Prativedan.
6Fact Sheet.
7Form prescribed by the Government of India Formet 2 Part I.
8Form prescribed by the Government of India Part II.
9Joint Site inspection Report.
10Alternative Route Alignment report.
11Justification for Land Format 11.
12Details for optional land Format 13.
13Certificate for Minimum Forest Land Format 14.
14Land Schedule Format 15.
15Certificate for Banj Tree Falling Details Format 16.
16Cross Section.
17Bar Chart Status.
18Undertaking for No work started.
19Details of Affected Trees Format 19.
20Undertaking for Banj Tree Falling Details Format 22.
21Certificate for Affected Tree Format 23.
22Undertaking for minimum Tree Falling Format 24.
23Certificate for Not Being Part of Wildlife Sanctuary Format 25.
24Certificate for dintance from National Park Format 26.
25Certificate for Wildlife Permission Format 27.
26Cert for Agreement bw LO And UA Format 48.
27Certificate for Availability of Kerosin and other Format 39.
28Certificate for CA Land Availability with Maps.
29Certificate for following Geologist recommendation Format 34.
30Certificate for NPV Calculation Format 42.
31Certificate for NPV Format 51.
32Check list of documents information required for proposal for diversion of forest land.
33Gazette Notification.
34Government of India FRA Circular.
35Manak Sharte Format 36.
36Muck disposal Plan Format 49_1.
37NOC of landowner Format 47.
38On both sides of the roadway and at the vacant places plantation work Format 46.
39Task Force Certificate Format 35.
40Undertaking for Benifited Village Format 40.
41Undertaking for CA land.
42Undertaking for Dharmik Pauranik Place Format 37.
43Undertaking for No damage for Forest Founa and Flowera Format 38.
44Undertaking for Submiting Layout plan for building construction Format 32.
45Village Wise Area Calculation Sheet.
46Segment Wise Area Calculation Sheet.
47Geo Referenced Digital Map with Coordinates prepared by Forest Department.
48Georeferenced Toposheet Map prepared by Forest Department.
49EDS Reply Letter Dated 05_03_2021.
50Undertaking for Various Component Format 31.
51EDS Reply Letter dated 28_12_2021 with Enclosures.
52Geological Report.
53FRA Certificate with Annxures.
54Sub Divisional Level Committee Meeting proceedings for FRA.
55Village Level Committee Meeting proceedings for FRA.
56Administrative and Financial Approval.
57CA Land Maps for Compensatory Afforestation.
58Form A Online Part 1 Field by user Agency
59Cost Benefit Analysis Report
60Compliance Report of EDS raised by Nodal Officer dated 24_02_2022
61Muck Disposal Plan