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/13103/2015   (ii). Name of Project for which Forest Land is required : Maniyachhina-Bhatgar motor road in District-Bageshwar   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Proposal for diversion of 1.6576 ha. forest land for construction of motor road. detail narrative attached form-11 (2.1) in additional enclosure.   (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) : 68.04   (viii). Area of forest land proposed for diversion(in ha.): 1.6576   (ix). Non-forest land required for this project(in ha.): 1.1424   (x). Total period for which the forest land is proposed to be diverted(in years): 50
A-2. Details of User Agency
  (i). Name : PROVINCIAL DIVISION PWD BAGESHWAR   (ii). Address1 : Provincial Division PWD Bageshwar   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Bageshwar   (vi). Pin : 263642   (vii). Landmark : Kathayatbara   (viii). Email address : pdpwdbgr@gmail.com   (ix). Landline Telephone No. : 5963-220006   (x). Fax No. : NIL   (xi). Mobile No. : 9412023055   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Nawal   (ii). Middle Name: Kishor   (iii). Last Name: Diwedi   (iv). Gender: Male   (v). Designation: Assistant Engineer   (vi). Address 1: Provincial Division PWD Bageshwar   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Bageshwar   (x). Tehsil: Bageshwar   (xi). Pin: 263642   (xii). Landmark: Kathayatbara   (xiii). Email Address: pdpwdbgr@gmail.com   (xiv). Landline Telephone No.: 5963-220006   (xv). Fax No.: 05963220006   (xvi). Mobile No.: 9719974196   (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.Bageshwar1.65761.1424
Total1.65761.1424
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bageshwar1.65761.1424
Total1.65761.1424
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Bhatgar0.28980.6524
2Maniyachhina00.21
3Sutargawn1.36780.28
Total 1.6576 1.1424
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road1.65761.1424
Total 1.6576 1.1424
C. Maps of forest land proposed to be diverted
Division 1. : Bageshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 1.6576   (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).
1.1.6576    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): 4   (iii). Temporary Employment(Number of person-days): 40
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: Badiyakot   (b). Area(in ha.): 3.3152   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 1   (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
11.1 Authority
21.2 Toposheet
31.3 Geo-referenced map
41.4 Google Map
51.5 Justification
61.6 FRA
71.7 Plantation toposheet
81.8 Plantation google map
91.9 Non-forest or Revenue forest land
102.1 A short narrative
112.2 Financial Sanction
122.3 Joint Inspection report
132.4 Comperative chart
142.5 Certificate from the DM
152.6 Land Schedule
162.7 Category wise
172.8 Bar chart
182.9 Compensatory afforestation scheme in civil
192.10 Certificate regarding
202.11 Undertaking by user agency
212.12 Road side/gap filling
222.13 Undertaking by the user agency
232.15 Details of the trees with their scientific name
242.16 Felling of oak trees
252.18 certificate of felling minimum trees
262.19 Muck disposal scheme
272.20 Whather project area is a part of national park
282.21 CCF wild life has to be provided
292.22 Project falling within the national park
302.23 FC Act. 1980
312.24 NOC from local gram sabhas.
322.27 Certificate work has not been started reg.
332.28 Geologist report
342.29 Task force report
352.30 Standard condition
362.31 certificate by user agency for complying the condition
372.32 geologist report/task force
382.33 No historical/monumental place
392.34 undertaking regarding no animal
402.35 undertaking LPG to labours involved in project
412.36 Bebefited village
422.37 NPV calculation certificate
432.43 Check lisht/Fact Sheet