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/14471/2015   (ii). Name of Project for which Forest Land is required : Basola-Bagdiyalgaoun-samaya motor road   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of motor road for connecting remote villages like Dang, Basola, Bagdiyalgaoun, Maniyargaoun, Kimoj of Thalisain Block, constituency Shreenagar State Uttrakhand. These villages are not benefited by 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) : 126   (viii). Area of forest land proposed for diversion(in ha.): 3.132   (ix). Non-forest land required for this project(in ha.): 7.824   (x). Total period for which the forest land is proposed to be diverted(in years): 100
A-2. Details of User Agency
  (i). Name : PWD   (ii). Address1 : CD PWD BAIJRO   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Pauri Garhwal   (vi). Pin : 246278   (vii). Landmark : NIL   (viii). Email address : eepwdbaijro@rediffmail.com   (ix). Landline Telephone No. : 1348-267116   (x). Fax No. : 1348-267116   (xi). Mobile No. : 9756885708   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: anil   (ii). Middle Name: kumar   (iii). Last Name: negi   (iv). Gender: Male   (v). Designation: amin   (vi). Address 1: cd pwd baijro   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Pauri Garhwal   (x). Tehsil: Thali Sain   (xi). Pin: 246278   (xii). Landmark: NIL   (xiii). Email Address: anilkumarbaijro@gmail.com   (xiv). Landline Telephone No.: 1348-267116   (xv). Fax No.: 01348267116   (xvi). Mobile No.: 9761180526   (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.Garhwal,Pauri3.1327.824
Total3.1327.824
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Pauri Garhwal3.1327.824
Total3.1327.824
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Bagdiyal gaoun0.321.08
2Samaya0.851.08
3Dang0.632.4
4Dandkhil0.352.064
5Basola0.081.2
Total 2.23 7.824
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road3.1327.824
Total 3.132 7.824
C. Maps of forest land proposed to be diverted
Division 1. : Garhwal,Pauri
  (i). Area of forest land proposed to be diverted(in ha.) : 3.132   (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).
1.3.132    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): 70
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. : Pauri Garhwal
  (a). Village: Dhonda   (b). Area(in ha.): 6.264   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 01   (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
12.1 A short narrative and importance of the project
22.2 Administrative and financial sanction
32.3 Preliminary joint inspection report
42.4 Comparative chart
52.5 no alternative sutable non forest land available
62.6 land shedule
72.7 Catagory wise land length width and area
82.8 bar chart
92.9 Compensatory Afforestation scheme in civil and soyam land 10 years
102.10 Sutability of identified land for Compensatory Afforestation
112.11 bear the cost of CAAfforestation
122.12 Road side gap filling plantation scheme
132.13 To bear the cost of road side plantation by user agency
142.14 Details of the trees
152.16 felling of the oak trees
162.18 certificate of felling minimum trees
172.19 muck disposal scheme 1
182.19 muck disposal scheme 2
192.20 Distance of the project from national park
202.23 No voilation has taken place FC act 1980
212.24 NOC from local gram sabha
222.27 work has not been started
232.28 Geologist report
242.29 Task force
252.30 complying the condition imposed in Standard conditions
262.30 complying the condition imposed in geologist report
272.32 No historical or relegeous place will be effected
282.33 Undertaking regarding no animal will be effected
292.34 Undertaking to Providing alternative fuel wood karosene or LPG
302.35 Benifited village families population
312.36 NPV calculation
322.37 Payment of NPV if Hon'ble supreem coart increses the rate
332.38 Cost of forest land and lease rent certificate
342.39 Certificate of lease to be diverted
352.39 demarcation of land to be diverted (R.C.C piller estimate)
362.40 demarcation of land to be diverted (R.C.C piller estimate)
372.41 Bear the cost of RCC piller by user agency
382.43 Check list/ Fact sheet
39Reply of EDS Dated 11-7-2016
40letter of point wise reply