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/ROAD/148569/2021   (ii). Name of Project for which Forest Land is required : Construction of 4 laning of Ghazipur –Ballia- UP/Bihar New Greenfield section from Km. 0.000 to 117.120 of NH-31 and construction of new Buxar Spur connectivity from km 0.000 to km 17.270 in the Ballia district of Uttar Pradeshstate   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of 4 lane green field highway between Ballia and Ghajipur, by considering the exsiting road whereever possible.in District Ballia, of Uttar Pradesh   (iv). State : Uttar Pradesh   (v). Category of the Proposal : Road   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 91587   (viii). Area of forest land proposed for diversion(in ha.): 0.49   (ix). Non-forest land required for this project(in ha.): 420.17   (x). Total period for which the forest land is proposed to be diverted(in years): 100
A-2. Details of User Agency
  (i). Name : NATIONAL HIGHWAY AUTHORITY OF INDIA PIU AZAMGARH   (ii). Address1 : National Highway Authority of India,PIU 20/104,1st Floor,Harbanspur,Azamgarh(UP)   (iii). Address2 : NIL   (iv). State : Uttar Pradesh   (v). District : Azamgarh   (vi). Pin : 276001   (vii). Landmark : NIL   (viii). Email address : piuazamgarh@gmail.com   (ix). Landline Telephone No. : 5462-260117   (x). Fax No. : 5462-260117   (xi). Mobile No. : 7860563333   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: Pradeep   (ii). Middle Name: Kumar   (iii). Last Name: Srivastava   (iv). Gender: Male   (v). Designation: PD   (vi). Address 1: Project Implementation Unit.20/104, 1st Floor,Harbanspur,Azamgarh UP   (vii). Address 2: NIL   (viii). State: Uttar Pradesh   (ix). District: Azamgarh   (x). Tehsil: Azamgarh   (xi). Pin: 276001   (xii). Landmark: NIL   (xiii). Email Address: piuazamgarh@nhai.org   (xiv). Landline Telephone No.: 5462-260117   (xv). Fax No.: 05462260117   (xvi). Mobile No.: 9936101899   (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 Ballia0.49420.17
Total0.49420.17
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Ballia0.49420.17
Total0.49420.17
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Akoni0.494.735
2Ibrahimabad Uparwar025.574
3Oujha Kacchua04.209
4Chanddiar024.272
5Bairiya016.657
6Shahapur04.675
7Lakra02.067
8Badhwalia01.513
9Awagilva01.69
10Hardarpur04.778
11Bankapur05.086
12Tikapur00.362
13Tikari06.4
14Mustafabad00.058
15Basaratpur05.999
16Sultanpur09.811
17Kotwari04.024
18Kalyanpur00.809
19Kuruchunda Akoni02.013
20TeteDad00.407
21Pahteekha01.938
22Teekha06.772
23Birpur00.051
24Cheruia03.565
25Narhi05.097
26Gangahara010.019
27Baina00.148
28Baghe ji02.68
29Sagarpalli09.822
30Darampur02.275
31Khap Nasirabad01.904
32Sarfuddinpur Urf Mubarakpur03.106
33Devariyakurdh01.067
34Khap Surfuddinpur01.994
35Khap Khori Pakar00.978
36Haibatpur Khap00.73
37Haibatpur05.021
38Parsipatti01.042
39Maldepur00.525
40Vijaipur06.902
41Bankata04.791
42Makdhumi00.207
43Bedua01.794
44Hirpur05.671
45Neori Taluka Jamuaon01.556
46Chandan pur00.907
47Kanspur01.889
48Palwarhi02.138
49Moorki04.95
50Jamuan03.581
51JamuanKishun Nagar03.403
52Mohan Chhapra03.403
53Nagwa08.895
54Harlal Chhapra02.23
55Janari07.637
56Janari Mafi01.589
57Bhel Sarh08.455
58Bhimpatti00.687
59Urgasenpur01.343
60Kachha Khas05.729
61Rampur Tithi07.014
62Pochhari03.475
63Pindari05.968
64Sihakhund05.913
65Bharkoka09.46
66Kathai01.492
67Mudadih015.48
68Laakhpur03.592
69Bolthari09.33
70Malikpura Mu. Jagchhapra03.709
71Dudaila04.971
72Khajuhati012.017
73Varuna Mu.Dighar03.65
74Raghunathpur Mu.Dighar00.714
75Kanchanpur04.855
76Kewa04.582
77Rampur03.793
78Cherdhi07.335
79Nauka Gao06.116
80Balihar00.337
81Daya Chhapra014.837
82Dalpatpur00.847
83Jagdev01.066
84Harakhpur04.934
85Tengarahi06.026
86Bhojapur06.469
87Sonabarsa02.313
88Kurchanda Mu singhur08.245
Total 0.49 420.17
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road0.49420.17
Total 0.49 420.17
C. Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Ballia
  (i). Area of forest land proposed to be diverted(in ha.) : 0.49   (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).
1.0.49    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: Yes   (a). Copy of map indicating location of alternative examined:
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 100   (iii). Temporary Employment(Number of person-days): 150000
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 ? : Yes   (a). Status of the Environmental Clearance to the Project: EC under process   (ii). Environmental Clearance File No.: 10/43/2021-IA.III
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
1Typical Cross Sections of the prposed road
2Index Map of the proposed project
3Project sanction letter from the ministry.
4Justification by the UA for locating the project in forest area
5Undertaking to pay for CA cost
6Undertaking to pay for additional NPV if any
7Undertaking to pay for exploitation of tree growth by the UA
8Undertaking to submit the FRA certificate from the district collector by UA
9Undertaking to demarcate the diverted land as part of the project by UA
10Undertaking to comply with any condition imposed by the forest department by UA
11Undertaking to establish no labor camp in side the forest area by UA
12Certificate to state that no archaeologically important site is falling in the project area by UA
13Document Verification certificate
14Checklist
15No work till stage - I is accorded
16No work in non forest area till stage - I is accorded
17No alternative land is available for the project
18Muck disposal Plan
19Undertaking to pay for tree transplantation
20Undertaking to pay for tree plantation on either side of the project road
21Undertaking to adher to standard conditions stipulated by the MoEF and CC
22Gazette notification highlighting the forest area under consideration
23UP forest Gazette notification
24Hard copy received by DFO
25Hard copy received by District Magistrate
26Proposed Area is the barest minimum
27Proposed Forest area for diversion
28Details of Non forest area required for the project
29Form - A of part 1
30To pay for the cost of NPV
31To pay for the cost of additional NPV if any
32Approval letter from the land owner