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/150368/2021   (ii). Name of Project for which Forest Land is required : Proposed Laying of Water Distribution Pipeline along different roads, under Salaiyya-Nathupura, Lahchoora-Kashipura, Dhawarra Sijwaha, Shivhar and Kabrai Group of Villages Drinking Water Supply Scheme of Jal Jeevan Mission of Govt Of India, in District:- Mahoba (UP).   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Proposed Forest Land to be Diverted for Laying of Water Distribution Pipeline along different roads, under Salaiyya-Nathupura, Lahchoora-Kashipura, Dhawarra Sijwaha, Shivhar and Kabrai Group of Villages Drinking Water Supply Scheme of Jal Jeevan Mission of Govt Of India, in District:- Mahoba.   (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) : 88238.28   (viii). Area of forest land proposed for diversion(in ha.): 14.4534   (ix). Non-forest land required for this project(in ha.): 25.8   (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 AND SANITATION MISSION   (ii). Address1 : OFFICE OF THE EXECUTIVE ENGINEER, CONSTRUCTION DIVISION CIVIL, JAL NIGAM RURAL, MAHOBA UTTAR PRADESH.   (iii). Address2 : NIL   (iv). State : Uttar Pradesh   (v). District : Mahoba   (vi). Pin : 210427   (vii). Landmark : NIL   (viii). Email address : eecivilmahoba.upjn.rural@gmail.com   (ix). Landline Telephone No. : 0-000   (x). Fax No. : 0-000   (xi). Mobile No. : 9450270479   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Arvind   (ii). Middle Name: Kumar   (iii). Last Name: Awasthi   (iv). Gender: Male   (v). Designation: AE   (vi). Address 1: OFFICE OF THE EXECUTIVE ENGINEER, CONSTRUCTION DIVISION CIVIL, JAL NIGAM RURAL, MAHOBA UTTAR PRADESH.   (vii). Address 2: NIL   (viii). State: Uttar Pradesh   (ix). District: Mahoba   (x). Tehsil: Mahoba   (xi). Pin: 210427   (xii). Landmark: NIL   (xiii). Email Address: eecivilmahoba.upjn.rural@gmail.com   (xiv). Landline Telephone No.: 0-000   (xv). Fax No.: 0000   (xvi). Mobile No.: 9450270479   (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 Mahoba14.453425.8
Total14.453425.8
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Mahoba14.453425.8
Total14.453425.8
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Jardin Ganj0.40
2Karhara Kalan0.320
3Supa0.270.421
4Rampura kadim00.1053
5Chamarra00.2054
6Charkhari0.270.566
7Dhawar00.385
8Sugira1.60.074
9Pathari Kadim00.326
10Kulpahar0.360.3113
11Bodi00.5062
12Panwari0.650
13Gado00.3235
14Bharwara1.150
15Raipur Kalan00.198
16Telipahari00.7825
17Kalhara Kalan0.20
18Saura00.4213
19Harpalpur0.150
20Garrauli00.4653
21Taiya0.120.816
22Naipura00.2482
23Umrai0.960
24Diwalo Pura00.115
25Bamhauri Kurmin0.550.592
26Bihar00.109
27Bahadarpur Kalan0.160
28Satari00.387
29Murehra0.60
30Rurikala00.2916
31Srinagar0.80.5873
32Chandpura00.1335
33Kaimaha0.40.5189
34Pachpehra0.10.2532
35Churari00.239
36Chand Pura0.13690
37Banguwan1.50
38Kharela0.0750.5165
39Chittarwara00.57
40Bhindawar0.410
41Kankua00.5206
42Dhikwaha00.7215
43Ratauli0.150.602
44Mirtala00.4353
45Rahelia00.2984
46Baghwa0.7130.3268
47Kabrai00.1993
48Pahra00.5867
49Sukaora0.5020.1625
50Amilahi00.7815
51Barbai00.7011
52Gorkha0.51811.0925
53Dhawari00.4086
54Indaura0.1320.1315
55Belatal0.09010
56Bagaul00.4437
57Basoth00.3623
58Daharra00.1875
59Balchaur0.020.7229
60Mudhari00.1403
61Rurikalan0.240.2916
62Pahretha00.2785
63Punniyan00.5532
64Tolapantar0.050
65Kahra00.4113
66Mawai Khurd00.4056
67Chauka0.0370.2943
68Ratwa00.3688
69Manki0.050.4201
70Rawatpura Khurd00.5574
71Charkhariya0.150
72Swasa Maf0.30
73Makarbai00.073
74Mochipura00.64
75Tikariya0.070.194
76Bhadarwara0.010.2072
77Rikhawaha0.0240
78Naigawan00.5562
79Rewai Sunecha00.2312
80Thathewra0.110.2011
81Karhara Dang0.10530.25
82Tindaoli00.2
83Tamora00.3735
Total 14.4534 25.8
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying of Drinking Water Pipeline14.453425.8
Total 14.4534 25.8
C. Maps of forest land proposed to be diverted
Division 1. : Forest Division Mahoba
  (i). Area of forest land proposed to be diverted(in ha.) : 14.4534   (ii). Nature of the Project: Linear   (b). No. of Segments : Five
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).
1.5.8652    View File
2.2.4271    View File
3.2.8111    View File
4.1.985    View File
5.1.365    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 Alternate
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 2   (iii). Temporary Employment(Number of person-days): 10000
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.): 12.0   (c). Area of non-forest or Revenue forest land required to be provided by User Agency for raising Compensatory Afforestation(in ha.): 4.126   (iii). No. of districts involved for raising Compensatory Afforestation: 1   (iv). No. of patches: One
District 1. : Mahoba
  (a). Village: SALAT   (b). Area(in ha.): 4.126   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 845D   (e). Present owner: User Agency   (f). Copy of Ownership proof:
  (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
1PROJECT SANCTION LETTER
2UNDERTAKING FOR CA DEPOSIT
3UNDERTAKING FOR ETT
4UNDERTAKING FOR FRA
5UNDERTAKING FOR MINIMUM TREE FELLING
6MUCK DISPOSAL PLAN
7STANDARD CONDITIONS
8VAIKALPIK VAN BHOOMI CERTIFICATE
9UNDERTAKING FOR VANYA JEEV VIHAR
10UNDERTAKING FOR NOT START WORK BEFORE FOREST APPROVAL
11UNDERTAKING FOR LEASE RENT
12RESERVE AND PROTECTED FOREST NOTIFICATION
13UNDERTAKING FOR NPV DEPOSIT
14AREA CALCULATION SHEET
15LAYOUT PLAN
16PWD NOC
17IRRIGATION NOC
18UNDERTAKING FOR OWNER DEPARTMENT NOC
19NHAI NOC