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/151514/2022   (ii). Name of Project for which Forest Land is required : Dhikuli Water Supply Scheme Under Jal Jeevan Mission (CM Declaration No.-605/2019)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : This proposal is prepared for supply of drinking water to dhikuli and nearby villages under jal jeevan mission(JJM). Due to unavailability of land for the construction of OverHead-Tank and Tubewell nearby, forest land is identified for the construction of OverHead-Tank and Tubewell.   (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) : 350   (viii). Area of forest land proposed for diversion(in ha.): 0.075   (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): NIL
A-2. Details of User Agency
  (i). Name : UTTARAKHAND PAYJAL SANSADHAN VIKAS AVAM NIRMAN NIGAM   (ii). Address1 : construction division pey jal nigaM RAMNAGAR   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Nainital   (vi). Pin : 244715   (vii). Landmark : NEAR LIC OFFICE   (viii). Email address : eecdujnramnagar@gmail.com   (ix). Landline Telephone No. : 5947-251259   (x). Fax No. : 5947-   (xi). Mobile No. : 8979108120   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: MUKESH   (ii). Middle Name: NIL   (iii). Last Name: KUMAR   (iv). Gender: Male   (v). Designation: A.A.E   (vi). Address 1: construction division pey jal nigam ramnagar   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Nainital   (x). Tehsil: Ramnagar   (xi). Pin: 244715   (xii). Landmark: NEAR LIC OFFICE   (xiii). Email Address: eecdujnramnagar@gmail.com   (xiv). Landline Telephone No.: 5947-251259   (xv). Fax No.: NIL   (xvi). Mobile No.: 9412143447   (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.Ramnagar0.0750
Total0.0750
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Nainital0.0750
Total0.0750
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1dhikuli0.0750
Total 0.075 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Rest area for accessbility and distribution line a0.0320
2Transformer with electricity line0.0020
3Pump house operator room0.0150
4Over Head Tank0.02250
5Tubewell0.00250
Total 0.074 0
C. Maps of forest land proposed to be diverted
Division 1. : Ramnagar
  (i). Area of forest land proposed to be diverted(in ha.) : 0.075   (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.
1.0.075    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): 2   (iii). Temporary Employment(Number of person-days): 3600
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
1Toposheet
2Geo-reference
3google earth map
4bar chart
5inspection report
6land schedule
7tree detail
8dharmik sthal certificate
9minimum tree cutting certificate
10muck dumping certificate
11no work execution certificate
12alternate alingment certificate
13comparative alternate alingment certificate
14FCA 1980 cetificate
15distance cetificate
16alternate land unavailability certificate
17FRA certificate
18no harm to wildlife certificate
19approval certificate
20Certificate Regarding Employment
21EDS reply
22Layout Plan
23Muck disposal Plan
24Index plan of Dhikuli Wss
25EDS Reply