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/Pipeline/147376/2021   (ii). Name of Project for which Forest Land is required : Permission for laying of 4" dia CS and 125 mm dia MDPE Gas Pipeline in the same trench along the Bareilly-Shahjahanpur Road NH-30 (Ch. 260.300 to 271.600) for approx 11300mtrs in Kaccha area for CNG/P   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Permission for laying of 4" dia CS and 125 mm dia MDPE Gas Pipeline in the same trench along the Bareilly-Shahjahanpur Road NH-30 (Ch. 260.300 to 271.600) for approx 11300mtrs in Kaccha area for CNG/PNG supply to customers nearby in Distt Bareilly   (iv). State : Uttar Pradesh   (v). Category of the Proposal : Pipeline   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 100   (viii). Area of forest land proposed for diversion(in ha.): 0.6215   (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 : CENTRAL UP GAS LIMITED   (ii). Address1 : Central UP Gas Ltd, 7th Floor, UPSIDC Complex, A-1/4   (iii). Address2 : Lakhanpur, Kanpur   (iv). State : Uttar Pradesh   (v). District : Kanpur Nagar   (vi). Pin : 208024   (vii). Landmark : Near Sales Tax Office   (viii). Email address : smohapatra@cugl.co.in   (ix). Landline Telephone No. : 512-2582468   (x). Fax No. : 512-   (xi). Mobile No. : 9793384455   (xii). Website (if any) : www.cugl.co.in   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Jitendra   (ii). Middle Name: NIL   (iii). Last Name: Gautam   (iv). Gender: Male   (v). Designation: Manager   (vi). Address 1: CUGL Pump Near Satelite Bus Stand Bareilly   (vii). Address 2: NIL   (viii). State: Uttar Pradesh   (ix). District: Bareilly   (x). Tehsil: Bareilly   (xi). Pin: 243001   (xii). Landmark: NIL   (xiii). Email Address: cuglbly@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 9999439780   (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.Social Forestry Division Bareilly0.62150
Total0.62150
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bareilly0.62150
Total0.62150
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Rajau Paraspur0.110
2Kesarpur0.02750
3Megi Nagla0.03850
4Jerh0.0440
5Sarai Patti Sabdalpur0.220
6Naugawan0.0440
7Gausganj Sarai0.04950
8Faridpur0.0880
Total 0.6215 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1CNG and PNG Supply0.62150
Total 0.6215 0
C. Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Bareilly
  (i). Area of forest land proposed to be diverted(in ha.) : 0.6215   (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).
1.0.6215    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: no alternative map
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): 50
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
1Area Calculation
2Layout
3Forest Notification
4CA Undertaking
5NPV Undertaking
6Standard Conditions
7PNGRB Authorization
8Muck Disposal
9Non Commencement of Work
10Undertaking for submit the hard copy of PWD Noc at the time of Submitting Hard Copies of Proposal to DM and DFO Office
11ETT Undertaking
12FRA Undertaking
13EDS Reply
14EDS Reply
15Covering Latter
16ROW Notification
17Authority Latter
18Vaikalpik Bhoomi
19Complete Proposal
20EDS Latter
21ROW Notification
22Authority Latter
23Vaikalpik Bhoomi
24Justification dt 08.01.2025
25Part 1 dt 08.01.2025
26Covering dt 08.01.2025