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/26800/2017   (ii). Name of Project for which Forest Land is required : Reliance 4G project for Laying of Optical Fibre Cable (OFC) along with Km. 0.00 to Km. 22.00 (Fatehpur to Joniha Marg), Km. 0.00 to Km. 36.00 Jonhia to Amoli (Sathigawan Road) & Km. 0.00 to Km. 16.00 Bindki to Fatehpur Marg (ODR), Km. 6.00 to Km. 15.00 Chaugdra to Bindki Marg (MDR-15) & Ganga Bridge to Fatehpur road on SH-13 Km 195.00 to 207.00 To   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Laying of Optical Fibre Cable (OFC) along with Km. 0.00 to Km. 22.00 (Fatehpur to Joniha Marg), Km. 0.00 to Km. 36.00 Jonhia to Amoli (Sathigawan Road) & Km. 0.00 to Km. 16.00 Bindki to Fatehpur Marg (ODR), Km. 6.00 to Km. 15.00 Chaugdra to Bindki Marg (MDR-15) & Ganga Bridge to Fatehpur road on SH   (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) : 234   (viii). Area of forest land proposed for diversion(in ha.): 0.9842   (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.Social Forestry Division Fatehpur0.98420
Total0.98420
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Fatehpur0.98420
Total0.98420
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Patel Nagar0.03250
2Kodi0.03230
3Dharpur0.02840
4Nargtrapur0.02930
5Diwanipur0.03650
6Mardanpur0.03230
7Sahaili0.03850
8Faridpur0.03320
9Joniha0.04230
10Daratralalpur0.03340
11Kashipur0.03350
12Manjhepur0.03860
13Barva0.02280
14Sadhigavan0.03230
15Gangpur0.02260
16Kulkhera0.02360
17Amoli0.03340
18Chkheri0.03460
19Kunwarpur0.03440
20Chakaliabad0.03510
21Dargasbad0.03250
22Bindki0.03250
23Madanpur0.02350
24Tendauli0.02740
25Korsam0.03230
26Alipur0.03260
27Pahar0.03360
28Tanda0.02340
29Sarila0.02360
30Satmeel0.02350
31Kamalpur0.02450
32Aladadpur0.02520
Total 0.9842 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying of OFC cable0.98420
Total 0.9842 0
C. Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Fatehpur
  (i). Area of forest land proposed to be diverted(in ha.) : 0.9842   (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).
1.0.9842    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 application(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): 855
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
2Forest Land Notification gazette_Fatehpur-UP
3One time Plantation of 20 Km In Forest Division Agra of Rs 1 Cr.9Lac.
4NOC/Primary authority permissions _Single window Permission of 18974 Kms from NHAI Morth
5Methodology of Laying of OFC
6Undertaking for DFO Fatehpur - for FRA Certificate
7Project Details In DFO Fatehpur
8Undertaking for Primary authority permission.
9Area Calculation of Forest Land of DFO Fatehpur-UP
10Area Calculation of Forest Land of DFO Fatehpur-UP
11NOC/Primary authority permissions of Fatehpur-UP