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/17505/2016   (ii). Name of Project for which Forest Land is required : Development and Upgradation of 2 lane to 2 lane with Paved shoulders of Tanda to Raebareilly Section of NH 232   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : MoRTH has decided to take up the development of various National Highways under NHDP (Tree Cutting Permission in Protected Forest land for Proposed Akbarpur bypass)coming in the jurisdiction of Ambedkar Nagar in the 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) : 106929   (viii). Area of forest land proposed for diversion(in ha.): 0.2652   (ix). Non-forest land required for this project(in ha.): 76.5   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : NHAI PIU RAEBAREILLY   (ii). Address1 : Project Implementation Unit, 784, Vishnu Nagar,   (iii). Address2 : NIL   (iv). State : Uttar Pradesh   (v). District : Raebareli   (vi). Pin : 229001   (vii). Landmark : Opposite Satyam Hospital   (viii). Email address : pdpiuraebareilly@gmail.com   (ix). Landline Telephone No. : 535-2702526   (x). Fax No. : 535-2702527   (xi). Mobile No. : 8005044371   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: Samar   (ii). Middle Name: Bahadur   (iii). Last Name: Singh   (iv). Gender: Male   (v). Designation: GM (Tech) cum PROJECT DIRECTOR   (vi). Address 1: Project Implementation Unit, 784, Vishnu Nagar   (vii). Address 2: Raebareli   (viii). State: Uttar Pradesh   (ix). District: Raebareli   (x). Tehsil: Rae Bareli   (xi). Pin: 229001   (xii). Landmark: Opposite Satyam Hospital   (xiii). Email Address: pdpiuraebareilly@gmail.com   (xiv). Landline Telephone No.: 535-2702526   (xv). Fax No.: 05352702526   (xvi). Mobile No.: 8127639827   (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 Ambedkar Nagar0.265276.5
Total0.265276.5
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Ambedkar Nagar0.265276.5
Total0.265276.5
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Sijhauli0.067219.8685
2Bijaygoan0.096.5
3Kalepur,Mubarkpur Dayadeeh,Maherua020.0589
4Nyotariya Mustafabad0.1085.6226
5Kaserua04.5
6Gohanna08
7Ratanpur07.5
8Afzalpur04.45
Total 0.2652 76.5
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Construction of Akbarpur bypass Ch.10.570 to ch 230.265276.5
Total 0.2652 76.5
C. Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Ambedkar Nagar
  (i). Area of forest land proposed to be diverted(in ha.) : 0.2652   (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).
1.0.2652    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: Construction of Akbarpur proposed bypass 0.144 PF
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): 90000
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
1PART-1,FORM A BY UA
2CA UNDERTAKING
3Land suitablity certificates
4certificates reg Ownership
5Cross section of the Project
6Index MAP project
7Conditional of UP GOVT
8Project sanction /Award of Project of NH-232
9Project sanction /Award of Project of NH-232
10land Acquisition Plan of Akbarpur Bypass of NH-232(Raebareli-Tanda section) marking the forest area for diversion area
11Details area under FCA-1980
12Details non forest land to be taken for acquisition of Proposed Akbarpur bypass
13Uundertaking of Compensatory AFFORESTATION(CA)
14Undertaking of Additional NPV
15Forest Gazette duly verified
16Toposheet/gt sheet akbarpur bypass
17Digital Geo reference MAP
18Justification reg locate in forest area
19UNDERTAKING OF CA
20authority letter
21Net Present Value (NPV)
22Bare Minimum Forestland
23certificate reg.muck dumping proposal
24certificate regno voilation of FCA-1980
25jUSTIFICATION REG, ALTERNATE OPTION
26CERTIFICATE REG. NO COURT CASE PENDING
27nOT REQUIREMENT OF pRIOR environment CLEARANCE THE LIGHT OF Moef notification
28revised AS PER AREA PART-1 FORM
29revised proposal with request letter ,area sheet under FCA,MINIMUM FOREST LAND UNDERTAKING DETAILS