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/27736/2017   (ii). Name of Project for which Forest Land is required : Construction of Lambagad (Nailbend)to Jhoomakhet Link Motor road under PMGSY   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The road is required for providing connectivity to Village -Kushrani Malli situated in Block-Gairsain of District Chamoli with a population of 347 numbers. The total length of the road is 3.50 km.The road passes through Private Land and Reserve forest Land   (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) : 388   (viii). Area of forest land proposed for diversion(in ha.): 2.4165   (ix). Non-forest land required for this project(in ha.): 1.155   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : RES PMGSY KARANPERAYAG   (ii). Address1 : Karanprayag   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Chamoli   (vi). Pin : 246444   (vii). Landmark : NIL   (viii). Email address : eepmgsykaranprayag1@rediffmail.com   (ix). Landline Telephone No. : 1363-244843   (x). Fax No. : 1363-0   (xi). Mobile No. : 9412056922   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: sachin   (ii). Middle Name: NIL   (iii). Last Name: kumar   (iv). Gender: Male   (v). Designation: Assistant Engineer   (vi). Address 1: Karanprayag   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Chamoli   (x). Tehsil: Karnaprayag   (xi). Pin: 246444   (xii). Landmark: NIL   (xiii). Email Address: eepmgsykaranprayag1@rediffmail.com   (xiv). Landline Telephone No.: 1363-244843   (xv). Fax No.: NIL   (xvi). Mobile No.: 7895282436   (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.Kedarnath Wild Life Division,Gopeshwar2.41651.155
Total2.41651.155
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Chamoli2.41651.155
Total2.41651.155
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Reserve Forest2.41650
2Kushrani Malli00.66
3Setho Jhoomakhet00.495
Total 2.4165 1.155
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road2.18250.9675
2Muck Disposal0.2340.1875
Total 2.4165 1.155
C. Maps of forest land proposed to be diverted
Division 1. : Kedarnath Wild Life Division,Gopeshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 2.4165   (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).
1.2.4165    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): 14400
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?: No   (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) . Reason for not providing Non-Forest Land: Others
Additional information Details
Documents
S.No Documents
Remarks
1Photogrraph of the road
2compensatory Afforestation land detail
3Muck disposal plan of the road
4Combined Inspection report
5Land schedule and Bar Chart
6Certificate for bearing the cost of road side plantation
7Certificate for Not staring the work
8FRA certificate
9Note containing importance of the project
10Datails of trees
11Preliminiry report of the project
12Part-1
13Task force and standard condition
14certificate for bearing the cost CA
15certificate for minimum number of trees
16Certificate that no violation of the FA 1980 has taken place
17Certificate that the project is not a part of National park or Sanctuary and the aerial distance.
18compensatory Afforestation scheme.
19Cost of the Demarcation of land to be diverted and Understanding of user agency to bear the cost for Demarcation work
20Certificate that no historical/monumental or religious place will be affected .
21Certificate for no alternative suitable non-forest land for the project and that demand is barest to the minimum.
22Certificate for no alternative NPV calculation Certificate as per Honable Supereme Court/MoEF orders and Understanding of payment of NPV,if Honable Supreme Court increases the rates of NPV.
23NPV details
24Undertaking to provide alternative fuel wood ,kerosene or LPG to labourers involved in the projectUndertaking to provide alternative fuel wood ,kerosene or LPG to labourer involved in the project
25Task force certificate
26Toposheet Map Of degraded forest land for CA
27Geo-Referance Of degraded forest land for CA
28Undertaking regarding no animal will be affected adversely by the project
29financial sanction and administrative sanction
30compensatory Afforestation suitability certificate
31Benefited Village Families Population Certificate
32EDS reply by User Agency on dated 09.07.19
33CA Suitability Certificate
34Muck Disposal Plan
35Geologist Report
36Muck Disposal Report
37EDS reply of User agency on Dated23.10.2019
38Revised Muck Disposal plan
39EDS reply by User Agency on dated 09.12.19
40EDS reply by User Agency on dated 23.01.20
41NPV Calculation Sheet