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/41672/2019   (ii). Name of Project for which Forest Land is required : Construction of Taknagunth to Dandamalla Motor Road   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The proposal has been made for construction of Taknagunth to Danda Malla M/R, Length 16.000 Km. under PMGSY champawat which shall provide connectivity to village Kaknai (501) and Danda Malla (288) with a total population of 789, thus total population 789 served with this 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) : 883   (viii). Area of forest land proposed for diversion(in ha.): 9.14   (ix). Non-forest land required for this project(in ha.): 5.22   (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   (ii). Address1 : OFFICE OF THE EXECUTIVE ENGINEER, IRRIGATION DIVISION (P.W.D.)CHAMPAWAT   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Champawat   (vi). Pin : 262523   (vii). Landmark : NEAR POST OFFICE   (viii). Email address : eepmgsychampawat@rediffmail.com   (ix). Landline Telephone No. : 5965-230148   (x). Fax No. : 5965-0   (xi). Mobile No. : 9411521847   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State PSU
A-3. Details of Person Making Application
  (i). First Name: Sanjay   (ii). Middle Name: NIL   (iii). Last Name: Tewari   (iv). Gender: Male   (v). Designation: ASSISTANT ENGINEER   (vi). Address 1: OFFICE OF THE EXECUTIVE ENGINEER, IRRIGATION DIVISION (P.W.D.)CHAMPAWAT   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Champawat   (x). Tehsil: Champawat   (xi). Pin: 262523   (xii). Landmark: NEAR POST OFFICE   (xiii). Email Address: eepmgsychampawat@rediffmail.com   (xiv). Landline Telephone No.: 5965-230148   (xv). Fax No.: NIL   (xvi). Mobile No.: 7534880799   (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.Haldwani9.145.22
Total9.145.22
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Champawat9.145.22
Total9.145.22
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Kaknai9.143.42
2Kathoti (Danda)01.8
Total 9.14 5.22
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road7.145.22
2Muck20
Total 9.14 5.22
C. Maps of forest land proposed to be diverted
Division 1. : Haldwani
  (i). Area of forest land proposed to be diverted(in ha.) : 9.14   (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).
1.9.14    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): 35000
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?: 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
1A short narrative and importance of the project.
2Administrative and Financial sanction.
3Preliminary Joint Inspection report (by user agency, forest department, revenue department
4Comperative chart showing statement of both alignment or alternate site explored for the proposed project and reasons for their rejection duly countersigned by DFO.
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
7Category wise (RF,civil soyam, Van panchayat and private nap land, Notified forest land etc.) land length, width and area in Ha.
8Bar Chart
9Compensatory afforestation scheme in Civil and Soyam land (10 years) by DFO.
10Certificate regarding suitability of indentified land for Comensatory Afforestation by DFO
11Undertaking by the User Agency to bear the cost of compensatory afforestation duly counter signed by the DFO.
12Undertaking by the User Agency to bear the cost of Road side /gap filling plantation (by user agency)
13Details 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.
14Details 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.
15If felling of trees is not involved, certificate by DFO in this regard.
16Certificate of felling minimum trees during the project work.
17Muck disposal scheme
18Whather project area is a part of National Park or sanctuary and airal distance of the project from National Park or sanctuary signed by DFO.
19If 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.
20No voilation has taken place, FC Act. 1980 reg.
21NOC from local Gram Sabhas.
22Certificate- work has not been started reg.
23Geologist Report.
24Task Force report.
25Certificate by user agency for complying the condition imposed in Standard Condition
26Certificate by user agency for complying the condition imposed in geologist report/Task force recommendation.
27No historical/monumental or relegeous place will be effected certificate reg. (by DM/DFO)
28Undertaking regarding no animal will be effected adversely by the project.
29Undertading to provide alternative fuelwood, kerosene or LPG to labours involved in project.
30Benefited villages/Families/Population Certificate.
31NPV calculation certificate as per Hon'ble Supreem court /MoEF orders by DFO.
32Undertaking of payment of NPV, if Hon'ble Supreem Court increses the rates of NPV (by user agency)
33Cost of the forest land and lease rent certificate by DM.
34Demarcation of land to be diverted
35Undertaking of user agency to bear the cost for demarcation work.
36Objection removal letter dated 06-09-2019
37Objection removal letter dated 28-09-2019
38Objection removal letter dated 12-12-2019
39EDS replay by UA on date 29-07-20