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/9917/2015
(ii). Name of Project for which Forest Land is required :
Construction of Leti-Riyasi to Tarkuli M/R under PMGSY.
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
The proposal has been made for construction of Leti-Riyasi to Tarkuli Motor Road under PMGSY which shall provide connectivity to villages Hiyali, Barkum, Riyasi Baman Gaon, Tarkuli, Amra with a total population of 1120. Thus total population being 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) :
694.6
(viii). Area of forest land proposed for diversion(in ha.):
4.98
(ix). Non-forest land required for this project(in ha.):
7.83
(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 Government
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.
Champawat
4.98
7.83
Total
4.98
7.83
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Champawat
4.98
7.83
Total
4.98
7.83
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
amra RF
1.68
0
2
amra
0
0.675
3
morkot RF
1.9
0
4
Tarkuli
0.84
2.475
5
Hiyali
0.35
1.44
6
Barkum
0.07
2.16
7
Riyasi Bamangaon
0.14
1.08
Total
4.98
7.83
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Road
4.48
6.09
2
muck
0.5
1.74
Total
4.98
7.83
C.
Maps of forest land proposed to be diverted
Division 1. : Champawat
(i). Area of forest land proposed to be diverted(in ha.) :
4.98
(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.
4.98
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):
10800
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 ?:
Yes
(iii). No. of districts involved for raising Compensatory Afforestation:
1
(iv). No. of patches:
One
District 1. : Champawat
(a). Village:
Degraded
(b). Area(in ha.):
9.96
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
purvi chheera
(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
1
If non-forest or Revenue forest land is required to be provided by User Agency? A Copy of ownership proof and No Objection Certificate
2
A short narrative and importance of the project
3
Administrative and Financial sanction
4
Preliminary Joint Inspection report (by user agency, forest department, revenue department
5
Certificate 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
6
Category wise (RF,civil soyam, Van panchayat and private nap land, Notified forest land etc.) land length, width and area in Ha
7
Bar Chart with index
8
Certificate of felling minimum trees during the project work
9
Whether project area is a part of National Park or sanctuary and airal distance of the project from National Park or sanctuary
10
No voilation has taken place, FC Act. 1980 reg
11
NOC from local Gram Sabhas
12
Certificate- work has not been started reg.
13
Geologist Report
14
Task Force report.
15
Certificate by user agency for complying the condition imposed in Standard Condition
16
Certificate by user agency for complying the condition imposed in geologist report/Task force recommendation in hill areas
17
No historical/monumental or relegeous place will be effected certificate reg
18
Undertakoing regarding no animal will be effected adversely by the project
19
Undertading to provide alternative fuelwood, kerosene or LPG to labours involved in project.
20
Benefited villages/Families/Population Certificate
21
Undertaking of payment of NPV, if Hon'ble Supreem Court increses the rates of NPV (by user agency)
22
Cost of the forest land and lease rent certificate
23
Authority Letter.
24
Objection removal letter.
25
Check List
26
Check list and Form A, Part 1 wide letter no 210/3pmgsy, dated 16-03-2018
27
NPV calculation as per guidline of honourable supreme court
28
muck disposal scheme
29
compensatry afforestation scheme
30
Objection removal letter.
31
Land Schdule
32
Details 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 )
33
Felling of Oak trees
34
Comparative chart showing statement of both alignment or alternate site explored for the proposed project and reasons for their rejection
35
Objection removal letter
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