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/153911/2022   (ii). Name of Project for which Forest Land is required : Green Gas Limited project for Laying of 10" Carbon Steel Gas Pipeline along NH - 731 (Left Side) from Km. 112.000 to Km. 115.588, from Km 122.413 to Km 129.293 & from Km 147.725 to Km 148.825 of Total Km. 11.568 & 0.34704 Ha. of Protected Forest in Social Forestry Division Amethi, District - Amethi, UP.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Green Gas Limited project for Laying of 10" Carbon Steel Gas Pipeline along NH - 731 (Left Side) from Km. 112.000 to Km. 115.588, from Km 122.413 to Km 129.293 & from Km 147.725 to Km 148.825 of Total Km. 11.568 & 0.34704 Ha. of Protected Forest in Social Forestry Division Amethi, District - Amethi,   (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) : 1157   (viii). Area of forest land proposed for diversion(in ha.): 0.34704   (ix). Non-forest land required for this project(in ha.): 0.75771   (x). Total period for which the forest land is proposed to be diverted(in years): 30
A-2. Details of User Agency
  (i). Name : GREEN GAS LIMITED   (ii). Address1 : 2nd Floor, Fortuna Tower, 10, Rana Pratap Marg   (iii). Address2 : NIL   (iv). State : Uttar Pradesh   (v). District : Lucknow   (vi). Pin : 226001   (vii). Landmark : NIL   (viii). Email address : gglup.up@gmail.com   (ix). Landline Telephone No. : 91-0-000000   (x). Fax No. : 91-   (xi). Mobile No. : 9716071618   (xii). Website (if any) : www.gglonline.net   (xiii). Legal status of User Agency : Joint Venture(Pvt+Govt.)
A-3. Details of Person Making Application
  (i). First Name: Vinay   (ii). Middle Name: NIL   (iii). Last Name: Bhardwaj   (iv). Gender: Male   (v). Designation: Chief Manager - Projects/OIC   (vi). Address 1: 1st Floor, 436, Atterdeep Complex, Devkali Bypass,   (vii). Address 2: NIL   (viii). State: Uttar Pradesh   (ix). District: AYODHYA   (x). Tehsil: NIL   (xi). Pin: 224001   (xii). Landmark: NIL   (xiii). Email Address: gglup.up@gmail.com   (xiv). Landline Telephone No.: 0-000000   (xv). Fax No.: NIL   (xvi). Mobile No.: 9716071618   (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 Amethi0.347040.75771
Total0.347040.75771
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Amethi0.347040.75771
Total0.347040.75771
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Kashtuni Purab0.025620
2Kashtuni Paschim0.046540
3Sarai Sulemani0.035480
4Khaudiya00.05853
5Ramnagar Urf Nayakot00.04837
6Ramraipur00.06932
7Kapoorchand Pur00.02853
8Pure Prem Shah0.037250
9Rampur urf Lokari0.046810
10Chak Baher0.038520
11Kanjas0.046340
12Salpur0.037480
13Bechugarh00.05648
14Tanda00.04593
15Badegaon00.04945
16Misharauli00.04783
17Arifpur00.03957
18Loshanpur00.04653
19Itraur00.03645
20Hasanpur Jareye00.04952
21Maraucha Tetarpur00.04842
22Siryari00.04057
23Malawa00.04283
24Garha00.04938
25Jagdishpur0.0330
Total 0.34704 0.75771
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying Of Gas Pipe Line0.347040.75771
Total 0.34704 0.75771
C. Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Amethi
  (i). Area of forest land proposed to be diverted(in ha.) : 0.34704   (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).
1.0.34704    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): 10   (iii). Temporary Employment(Number of person-days): 116
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
1Standard condition
2Undertaking for C.A.
3PNGRB Authorization letter
4Marked Gazette notification
5Methodology of Laying of Gas Pipeline
6NOC/Primary authority permissions of DFO Amethi - UP
7Undertaking for NPV
8Project Details In DFO Amethi - UP
9Undertaking for Entire Tree Transplant (ETP)
10Undertaking for work not start
11Undertaking of FRA Certificate for DFO Amethi - UP
12Undertaking for NOC of Primary authority permissions of DFO Amethi-UP
13Undertaking for Muck Disposal
14GPS Coordinate of propose route
15Area Calculation of Protected Forest Land of DFO Amethi - UP
16Area Calculation of Non-Protected Forest Land of DFO Amethi - UP