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/39053/2019   (ii). Name of Project for which Forest Land is required : Construction of Tanakpur Tawaghat M/R to Sigda Motor Road   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Tanakpur Tawaghat M/R to Sidga Motor Raod is proposed to connect 757 population with road of 8.250 km, which is estimated to connect the village with highway making the villagers accessible to social facilities such as road, school, hospital etc.   (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) : 518   (viii). Area of forest land proposed for diversion(in ha.): 3.9115   (ix). Non-forest land required for this project(in ha.): 4.3245   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : PMGSY LOHAGHAT   (ii). Address1 : Executive Engineer PMGSY Lohaghat   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Champawat   (vi). Pin : 262524   (vii). Landmark : NIL   (viii). Email address : eepmgsylohaghat@rediffmail.com   (ix). Landline Telephone No. : 5965-234118   (x). Fax No. : 5965-0   (xi). Mobile No. : 9837021815   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Deepika   (ii). Middle Name: NIL   (iii). Last Name: Bisht   (iv). Gender: Female   (v). Designation: Junior Engineer   (vi). Address 1: Executive Engineer PMGSY Lohaghat   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Champawat   (x). Tehsil: Lohaghat   (xi). Pin: 262524   (xii). Landmark: NIL   (xiii). Email Address: eepmgsylohaghat@rediffmail.com   (xiv). Landline Telephone No.: 5965-234118   (xv). Fax No.: NIL   (xvi). Mobile No.: 5965234118   (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.Champawat3.91154.3245
Total3.91154.3245
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Champawat3.91154.3245
Total3.91154.3245
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Chhira Comp 22,233.70150
2Sigda0.214.3245
Total 3.9115 4.3245
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road Construction3.11153.4245
2Muck Disposal0.80.8999
Total 3.9115 4.3244
C. Maps of forest land proposed to be diverted
Division 1. : Champawat
  (i). Area of forest land proposed to be diverted(in ha.) : 3.9115   (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).
1.3.9115    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): 20000
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 ?: Not Applicable   (iii) . Reason for not providing Non-Forest Land: Others
Additional information Details
Documents
S.No Documents
Remarks
1Non encumbarance
2EDS Dated 13.03.2019
3GO of Road
4Comperative chart showing statement of both alignment or alternate site explored for the proposed project and reasons for their rejection duly countersigned by DFO' (pdf file)
5Certificate from the DM that no alternative suitable non-forest land is available for the project in question and the demand of the forest land for the project is barest minimum
6Land schedule (for civil soyam, Van panchayat and private nap land signed by DM). (pdf file)
7Category wise (RF,civil soyam, Van panchayat and private nap land, Notified forest land etc.) land length, width and area in Ha. (pdf file)
8Bar Chart with index (counter signed by DFQ)' (pdf file)
9undertaking by the User Agency to bear the cost of compensatory afforestation duly counter signed by the DFo (pdf file)
10Road side/gap filling plantation estimate (by DFO) (pdf file)
11by the User Agency to bear the cost of Road undertaking side /gap filling plantation (by user agency) (pdf file)
12Details of the trees with their scientific name in RF, Civil Soyam, Van Panchayat, Private Notified land and in Nap Land should be mentioned (with valuation of the trees to be felled ) (0-10 dia trees will be mentioned as saplings). (pdf file)Tree count
13Felling of Oak trees (if involves, inspection report of the concerning CF has to be provided). (pdf file)
14Certificate of felling minimum trees during the project work. (pdf file)
15Whather project area is a part of National Park or sanctuary and airal distance of the project from National Park or sanctuary signed by DFO" (pdf file)
16lf the project area is within 10 Km radius of N/P or Centuary, Comments/No objection certificate of CCF Wild Life has to be provided.
17No voilation has taken place, FC Act. 1980 reg'
18NOC from local Gram Sabhas' (pdf file)
19Certificate- work has not been started reg. (pdf file)
20Geologist Report (Govt. approved Geologist). (pdf file)
21Task force report
22Standard Condition
23Certificate by user agency for complying the condition imposed in Standard Condition (pdf file)
24Certificate by user agency for No historical/monumental or relegeous place will be effected certificate reg. (by DM/DFO) (pdf fite
25Undertaking regarding no animal will be effected adversely by the project. (Pdf file)
26Undertading to provide alternative fuelwood, kerosene or LPG to labours involved in project. (pdf file)
27Benefited villages/Families/population Certificate. (pdf file)
28Undertaking of payment of NpV, if Hon'ble Supreem Court increses the rates of NpV (by user agency) (pdf file)
29Demarcation of land to be diverted (pdf file)
30Undertaking of user agency to bear the cost for dimarcation work (pdf file)
31certificate of tree felling
32fax sheet
33reply of EDS dated 17-06-2019
34EDS dated 12-09-2019
35Reply of EDS Dated 28-09-2019
36joint inspection report
37Land schedule (for RF signed by DFO
38EDS dated 04/11/2019
39Cost of the forest land and lease rent certificate by DM, (pdf file)
40Reply of EDS dated 04-12-2019
41NPV calculation sheet
42EDS dated 31.01.2020
43lf the project area is within 10 Km radius of N/P or Centuary, Comments/No objection certificate of CCF Wild Life has to be provided.
44Muck disposal scheme (in prescribed format) (pdf file)
45Certificate issued by DFO regarding VDF/MDF
46Certificate Regarding. suitability of indentified land for Comensatory Afforestation by DFO (pdf file)
47Compensatory afforestation scheme in Civil and Soyam land (10 years) bY DFO (Pdf file)
48Reply Of EDS Dated 05-06-2020