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/WATER/148758/2021
(ii). Name of Project for which Forest Land is required :
Leduki group of rural water supply project in bundelkhand / vindhya region and quality affected aeras is state of uttar pradesh ,Distt - Mirzapur
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
purpose of pure drinking water of Leduki group of rural water supply project in bundelkhand / vindhya region and quality affected aeras is state of uttar pradesh ,Distt - Mirzapur
(iv). State :
Uttar Pradesh
(v). Category of the Proposal :
Drinking Water
(vi). Shape of forest land proposed to be diverted :
Linear
(vii). Estimated cost of the Project(Rupees in lacs) :
24019.22
(viii). Area of forest land proposed for diversion(in ha.):
3.3169
(ix). Non-forest land required for this project(in ha.):
43.251
(x). Total period for which the forest land is proposed to be diverted(in years):
30
A-2.
Details of User Agency
(i). Name :
STATE WATER SANITATION MISSION
(ii). Address1 :
behind the tehsil officer colony mahuwariya mirzapur
(iii). Address2 :
NIL
(iv). State :
Uttar Pradesh
(v). District :
Mirzapur
(vi). Pin :
231001
(vii). Landmark :
jal nigam compound
(viii). Email address :
shashanks618@gmail.com
(ix). Landline Telephone No. :
0-
(x). Fax No. :
0-
(xi). Mobile No. :
9685668349
(xii). Website (if any) :
NIL
(xiii). Legal status of User Agency :
State PSU
A-3.
Details of Person Making Application
(i). First Name:
Sandeep
(ii). Middle Name:
NIL
(iii). Last Name:
Singh
(iv). Gender:
Male
(v). Designation:
Executive Engineer
(vi). Address 1:
Abav Khand Bhatua Road Nakahara
(vii). Address 2:
NIL
(viii). State:
Uttar Pradesh
(ix). District:
Mirzapur
(x). Tehsil:
Mirzapur
(xi). Pin:
231001
(xii). Landmark:
Ghandhi Ghat
(xiii). Email Address:
jalnigammirzapurswsm@gmail.com
(xiv). Landline Telephone No.:
0-
(xv). Fax No.:
NIL
(xvi). Mobile No.:
7571080264
(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.
Forest Division Mirzapur
3.3169
43.251
Total
3.3169
43.251
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Mirzapur
3.3169
43.251
Total
3.3169
43.251
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
Harda
0.0187
1.374
2
Karauda
0.4165
1.2585
3
Babhanithapanva
0.119
0.952
4
Padariya Kala
0.2035
0.814
5
Padariya Khurd
0.051
0.51
6
Serva
0.0659
0.659
7
Raikra
0.2506
2.506
8
Gadwa
0.1471
1.7652
9
Sarsawa
0.0799
2.9862
10
Leduki
0.0409
2.8227
11
Hardi Kala
0.3316
1.658
12
Atraila Pandey
0.0187
0.2244
13
Sirsi
0.0125
0.1875
14
Ghori
0.0175
0.35
15
Piuri
0.053
0.53
16
Bharetha
0.1565
1.5665
17
Asandi
0.0327
0.4905
18
Samsadiya
0.2015
2.418
19
Ganda
0.0253
1.3301
20
Hardi Mishra
0.023
0.437
21
Atari
0.062
1.706
22
Devari Uttar
0.0115
0.4025
23
Patehra
0.1547
13.2376
24
Bahuti
0.5204
1.4468
25
hadaura
0.1079
1.6185
26
Madihan-1
0.06
0
27
Madihan-2
0.09
0
28
Vindhyam
0.045
0
Total
3.3169
43.251
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
pipe line
3.3169
43.251
Total
3.3169
43.251
C.
Maps of forest land proposed to be diverted
Division 1. : Forest Division Mirzapur
(i). Area of forest land proposed to be diverted(in ha.) :
3.3169
(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.
3.3169
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):
36
(iii). Temporary Employment(Number of person-days):
80000
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? :
Yes
(a). Copy of documentry evidence in support of settlement of rights under the Forest Rights Act,2006 on the forest land proposed to be diverted:
L.
Details of land identified for Compensatory Afforestation
(i). Whether non-forest or Revenue forest land is required to be provided by User Agency?:
Yes
(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 ?:
Yes
(a). Reason Category:
CA Will be raised on degraded forest land as well as on land provided by User Agency
(b). Degraded forest area on which CA has to be raised by forest department(in ha.):
0.5
(c). Area of non-forest or Revenue forest land required to be provided by User Agency for raising Compensatory Afforestation(in ha.):
NIL
(iii). No. of districts involved for raising Compensatory Afforestation:
1
(iv). No. of patches:
One
District 1. : Mirzapur
(a). Village:
Matwar
(b). Area(in ha.):
3.1219
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
462 kmi
(e). Present owner:
User Agency
(f). Copy of Ownership proof:
District 2. : Mirzapur
(a). Village:
VIJAYPUR
(b). Area(in ha.):
0.5
(c). Copy of KML file of the patch:
View File
(d). Khasra details:
DADARKALA CO.NO. 3
(e). Present owner:
Others
(f). Copy of ownership proof:
(g). Copy of Mou/agreement executed between the Present owner and the User Agency:
(h). Copy of non encumberence certificate for the forest land:
(v). Scanned copy of the map of the land identified for creation of Compensatory Afforestation prepared by using GPS ot Total Station:
(vi). Copy of Survey of India Toposheet in 1:50,000 scale indicating location of the land identified for creation of Compensatory Afforestation:
Additional information Details
Documents
S.No
Documents
Remarks
1
Site Photograph
2
cross section
3
Justification note certificate
4
manak
5
certificate
6
certificate
7
certificate
8
Jan Jati
9
Population certificate
10
liz rent certificate
11
Addl land certificate
12
vailkalpic
13
Calculation of NON Forset land & Forest land
14
aarchit bhumi
15
Muk Disposal
16
Malwa Certificate
17
NVP
18
NVP Payment
19
Project sanction
20
Gazette
21
tree certificate
22
NVP Payement
23
Village wise breakup details
24
CA Land Khatauni
25
EDS
26
Eds
27
NOC
28
Vachanbadhata
29
Component breakup
30
Eds
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