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/UP/Others/23194/2016   (ii). Name of Project for which Forest Land is required : Reliance 4G project for Laying of Optical Fibre (OFC) cable along with road in Forest Division/Social Forestry Division Lucknow- UP, Grand total Km. 90.45 & 0.9533 Ha.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Reliance 4G project for Laying of Optical Fibre (OFC) cable along with road in Forest Division/Social Forestry Division Lucknow- UP, Grand total Km. 90.45 & 0.9533 Ha.   (iv). State : Uttar Pradesh   (v). Category of the Proposal : Others   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 226   (viii). Area of forest land proposed for diversion(in ha.): 0.9533   (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): 30
A-2. Details of User Agency
  (i). Name : Reliance Jeo Infocomm Ltd   (ii). Address1 : 3rd Floor, Maker Chamber IV, 222, Nariman point Mumbai   (iii). Address2 : NIL   (iv). State : Maharashtra   (v). District : Mumbai City   (vi). Pin : 400021   (vii). Landmark : Maker Chamber   (viii). Email address : pankaj.khare@ril.com   (ix). Landline Telephone No. : 22-22785500   (x). Fax No. : 22-22785560   (xi). Mobile No. : 9307663270   (xii). Website (if any) : ril.com   (xiii). Legal status of User Agency : Others
A-3. Details of Person Making Application
  (i). First Name: Pankaj Khare   (ii). Middle Name: NIL   (iii). Last Name: Khare   (iv). Gender: Male   (v). Designation: Manager   (vi). Address 1: IInd Floor,Rohtas”Ks”Trid Building,Rana Pratap Marg,Near Sikandarbag Chouraha,Lucknow   (vii). Address 2: NIL   (viii). State: Uttar Pradesh   (ix). District: Lucknow   (x). Tehsil: NIL   (xi). Pin: 226001   (xii). Landmark: Behind Doordarshan Building   (xiii). Email Address: pankaj.khare@ril.com   (xiv). Landline Telephone No.: 522-4939062   (xv). Fax No.: NIL   (xvi). Mobile No.: 9307663270   (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
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
1InprincipleFP/UP/Others/26031/2017FP/UP/Others/26031/20170.81890.818927 Sep 2018
2InprincipleFP/UP/Others/23197/2016FP/UP/Others/23197/20160.6890.68902 Aug 2017
3InprincipleFP/UP/Others/32529/2018FP/UP/Others/32529/20180.83980.839826 Sep 2018
4InprincipleFP/UP/Others/26800/2017FP/UP/Others/26800/20170.98420.984212 Feb 2018
Total 3.3319 3.3319
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.Awadh Forest Division Lucknow0.95330
Total0.95330
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Lucknow0.95330
Total0.95330
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Park Road0.02540
2Sarva Palli0.02120
3Mohanlal ganj0.02170
4Butterfly Over Bridge0.02210
5Terhipuliya0.02690
6Adil Nagar0.02650
7Jankipuram0.02290
8Bhitoli Khurd0.02530
9Roodohi0.02270
10Banoga0.02170
11Itunja0.02310
12Ashish Nagar0.02470
13Khurram Nagar0.02250
14Chinhat0.02290
15Gadia0.02330
16IIM Chauraha0.02540
17Raipur0.02170
18Sikrauri0.02130
19Habibpur0.02470
20Kanar0.02360
21Malihabad0.02290
22Aishbagh0.02430
23Mohan Road0.02270
24Kakori0.02170
25Bhatau Jamalpur0.02260
26Basrela0.02470
27Dariyapur0.02450
28Ghoshalalpiur0.02290
29Awadh Hospital0.02320
30Bhola Khera0.02270
31Mehndi Khera0.02170
32Avanti Vihar Colony0.02130
33Fatehganj0.02690
34Khushal ganj0.02650
35Gvalpur0.02290
36Shivari0.02210
37Saraimuhib0.02140
38Araji Mohan Jageer0.02170
39Mohan0.02040
40Vivekanand Marg0.02420
41Amar Shaheed Path0.02240
Total 0.9533 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying of OFC cable0.95330
Total 0.9533 0
C. Maps of forest land proposed to be diverted
Division 1. : Awadh Forest Division Lucknow
  (i). Area of forest land proposed to be diverted(in ha.) : 0.9533   (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).
1.0.9533    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: No   (a). Reason for not providing such map: Not Applicable (Along with Road)
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 9   (iii). Temporary Employment(Number of person-days): 814
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? : No
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
1IP Licence from Ministry of Telecommunications n Name Change
2One time Plantation of 20 Km In Forest Division Agra of Rs 1 Cr.9Lac.
3NOC/Primary authority permissions (Single window Permission of 18974 Kms from NHAI Morth )of Lucknow -UP
4NOC/Primary authority (NHAI/PWD/PMGSY )permissions of Lucknow -UP
5Methodology of Laying of OFC
6Forest Land Notification gazette
7Area Calculation of Forest Land of DFO Lucknow-UP
8Undertaking for DFO Lucknow for FRA Certificate.
9Undertaking for DFO Lucknow for Primary authority permission.
10Project Details In DFO Lucknow - UP