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/7840/2014   (ii). Name of Project for which Forest Land is required : Charma Jaurasi To Bajani Motor Road   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : This Road will connect Bajani habitation which starts from Jaurasi and it ends at Bajani.The length of road is 2.538 Km,and passes through civil soyam forest and nap land in which 1.6542 hectares of Civil soyam land is required in this project.   (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) : 124.88   (viii). Area of forest land proposed for diversion(in ha.): 1.6542   (ix). Non-forest land required for this project(in ha.): 0.63   (x). Total period for which the forest land is proposed to be diverted(in years): 50
A-2. Details of User Agency
  (i). Name : P.M.G.S.Y Didihat   (ii). Address1 : P.M.G.S.Y Didihat   (iii). Address2 : Didihat   (iv). State : Uttarakhand   (v). District : Pithoragarh   (vi). Pin : 262542   (vii). Landmark : P.M.G.S.Y   (viii). Email address : eepmgsydidihat@rediffmail.com   (ix). Landline Telephone No. : 5964-232036   (x). Fax No. : 5964-   (xi). Mobile No. : 9456590705   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Gurpreet   (ii). Middle Name: NIL   (iii). Last Name: Singh   (iv). Gender: Male   (v). Designation: Assistant Engineer   (vi). Address 1: P.M.G.S.Y Didihat   (vii). Address 2: P.M.G.S.Y Didihat   (viii). State: Uttarakhand   (ix). District: Pithoragarh   (x). Tehsil: NIL   (xi). Pin: 262542   (xii). Landmark: P.M.G.S.Y   (xiii). Email Address: eepmgsydidihat@rediffmail.com   (xiv). Landline Telephone No.: 5964-232036   (xv). Fax No.: 5964232036   (xvi). Mobile No.: 7251999486   (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.Pithoragarh1.65420.63
Total1.65420.63
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Pithoragarh1.65420.63
Total1.65420.63
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Bajani,Lima Bhat,Jaurasi1.65420.63
Total 1.6542 0.63
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
111.65420.63
Total 1.6542 0.63
C. Maps of forest land proposed to be diverted
Division 1. : Pithoragarh
  (i). Area of forest land proposed to be diverted(in ha.) : 1.6542   (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).
1.1.6542    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): 308   (iii). Temporary Employment(Number of person-days): 5
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. : Pithoragarh
  (a). Village: Bajani   (b). Area(in ha.): 3.3084   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 3736,3738   (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
1Adminstrative sanction (2.2)
2mang nuntam(2.5)
3land schedule(2.6)
4Category wise detail(2.7)
5compansatory afforation (2.9)
6compansatory afforation thal upyukt(2.10)
7compansatory afforation cost (2.11)
8Rikt pade sthano par trees
9Botnical name of trees att.2.15
10Oak tree certificateatt.2.16
11Minimum trees to cut certificate att.2.18
12Rashtriye park related att.2.20
13Rashtriye park se doorie att.2.21
14FC 1980 latter att.2.23
15component wise detail att.2.26
16work has not started att.2.27
17Geologist report att.2.28
18Task force certificate att.2.29
19Geo and task force certificate for hilly areas att.2.32
20No historical monument will b effected certificate att.2.33
21Providing kerosene and fuel certificate att.2.35
22NPV calculation certificate att.2.37
23NPV by supreem court att.2.38
24lease rent certificate att.2.39
25Fact sheet att.2.44
26Comparison details of alignment (2.4)
27N.O.C (1.9)
28Mou (1.10)
29Short nerrative and importance(2.1)
30To Bear the cost of CA (A-2.13)
31Manak Sharto ka certificate (A-2.31)
32Manak Sharto (A-2.30)
33Path Vriksharopan Estimate (A-2.12)
34Length And width Detail (A-2.7)
35Bar chart (A-2.8)
36Detailed muck dumping latters (A-2.19)
37No animal will be affected (A-2.33)
38joint inspection report(A-2.3)
39Comparison chart (A-2.4)
40Benifited Villages (A-2.36)
41N.O.C from Aam Sabha (A-2.24)
42Demarcation Of Land(A-2.41)