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/WATER/124331/2021   (ii). Name of Project for which Forest Land is required : Construction of Gumaniwala Water Supply Scheme (Peri Urban)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : This proposed program is to be implemented by Uttarakhand Jal Sansthan . Objective of the program is to provide an adequate, continuous water supply on 24*7 basis and metered drinking water supply to Gumaniwala & other nearest area households. This project also provide employment for local peoples.   (iv). State : Uttarakhand   (v). Category of the Proposal : Drinking Water   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 1650   (viii). Area of forest land proposed for diversion(in ha.): 0.25   (ix). Non-forest land required for this project(in ha.): 0   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : UTTARAKHAND JAL SANSTHAN RISHIKESH   (ii). Address1 : Mothrowala Dehradun   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Dehradun   (vi). Pin : 248001   (vii). Landmark : NIL   (viii). Email address : eemdwb@gmail.com   (ix). Landline Telephone No. : 0-   (x). Fax No. : 0-   (xi). Mobile No. : 7579287780   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Kamlesh   (ii). Middle Name: NIL   (iii). Last Name: Pant   (iv). Gender: Male   (v). Designation: Junior Engineer   (vi). Address 1: Mothrowala Dehradun   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Dehradun   (x). Tehsil: Dehradun   (xi). Pin: 248001   (xii). Landmark: NIL   (xiii). Email Address: kamleshpant13@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 7579287780   (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.Dehradun0.250
Total0.250
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Dehradun0.250
Total0.250
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Gumaniwala0.250
Total 0.25 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Overhead Tank0.0050
2Chambers0.0010
3Pipeline0.0050
4Security Work0.2270
5Scada Control Room0.010
6Pump House0.0020
Total 0.25 0
C. Maps of forest land proposed to be diverted
Division 1. : Dehradun
  (i). Area of forest land proposed to be diverted(in ha.) : 0.25   (ii). Nature of the Project: Non Linear   (a). No. of patches : One
Patch wise details
Patch No. Area of Patch(in ha.) Kml File of PatchesTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0.25    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:
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): 1500
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?: Not Applicable   (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: Not Applicable
Additional information Details
Documents
S.No Documents
Remarks
1Authority Letter
2Justification
3Administrative & Financial Sanction
4Land Schedule
5Bar Chart
6Beneficial Villages
7Digital Map
8Georefrence Map
9Geologist Report
10Effected Trees
11Effected Trees Regarding Documents
12Geologist Advise Comliance
13Banj Trees Regarding
14FRA Documents
15|Joint Inspection Report
16Layout Plan
17Minimum Demand For Forest Land
18Minimum Tree Felling
19Availability of Gas for Labour
20Standard Conditions
21Historical & Religion Place regarding
22No Effect on Vegetation & Wildlife
23NPV Regarding Documents
24Not a Part of NP or WLS
25Project Length or Width
26Proposal of RCC Pillar
27Task Force Certificate
28Alternative Alignment
29Comparative Statement for different Alternates.
30Work Not Start
31Aerial Distance Certificate