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/152122/2022   (ii). Name of Project for which Forest Land is required : Diverted Laying of Water Distribution Line along different roads, under Raipura Group of Villages Drinking Water Scheme of Jal Jeevan Mission of Govt. of India, in District:-Chitrakoot.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Proposed forest land to be diverted Laying of Water Distribution Line along different roads, under Raipura Group of Villages Drinking Water Scheme of Jal Jeevan Mission of Govt. of India, in District:-Chitrakoot.   (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) : 24846   (viii). Area of forest land proposed for diversion(in ha.): 4.70583   (ix). Non-forest land required for this project(in ha.): 8.4704   (x). Total period for which the forest land is proposed to be diverted(in years): 30
A-2. Details of User Agency
  (i). Name : UTTAR PRADESH WATER SUPPLY AND SANITATION MISSION   (ii). Address1 : OFFICE OF THE U.P. JAL NIGAM COMPOUND, 6- RANA PRATAP ROAD LUCKNOW.   (iii). Address2 : NIL   (iv). State : Uttar Pradesh   (v). District : Lucknow   (vi). Pin : 226001   (vii). Landmark : NIL   (viii). Email address : vijayjalnigamrural@gmail.com   (ix). Landline Telephone No. : 91-0522-2239428   (x). Fax No. : 91-   (xi). Mobile No. : 9616377202   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Vijay   (ii). Middle Name: Shankar   (iii). Last Name: Yadav   (iv). Gender: Male   (v). Designation: JE   (vi). Address 1: OFFICE OF THE PROJECT MANAGER TEMP.CONS.UNIT.U.P. JAL NIGAM (RURAL) DHUS MAIDAN KARWAI.   (vii). Address 2: NIL   (viii). State: Uttar Pradesh   (ix). District: Chitrakoot   (x). Tehsil: NIL   (xi). Pin: 210205   (xii). Landmark: NIL   (xiii). Email Address: vijayjalnigamrural@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 9454012816   (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 Chitrakoot (Karvi)4.705838.4704
Total4.705838.4704
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Chitrakoot4.705838.4704
Total4.705838.4704
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Rukamakhurd0.09450.1027
2Jhilang0.07810.1734
3Karkapandriya0.05040
4Bahilpurwa0.38170.5215
5Semardaha0.07470.1876
6Madaiyan00.2346
7Kharoundh0.183750.3996
8Chandramara0.0750.307
9Sahdol0.15590
10Sarainya0.0420.7364
11Sarhat00.1403
12Pata00.0499
13Choolhi0.45030.423
14Jhari0.20.2046
15Umari0.1050
16Jabarjasta0.08080
17Churehkesarua0.717780.1247
18Nand Baniya0.060.201
19Manikpur Rural00.319
20Manikpur0.2480
21Hela00.0474
22Khichari00.154
23Manikpur Sarhat00.3324
24Agarhunda0.230.9978
25Hanuwa0.040.182
26Gadhchapa0.0240.8478
27Chartaha0.0150.1075
28Madna0.030.0791
29Pwari Kala0.026250.3521
30Gouria00.2999
31Raipura0.603750
32Chheriha Bujurg0.33150.0952
33Achur Nerua0.170.4339
34Markundi0.09940.2786
35Chheriha Khurd0.0420.0659
36Kahdol0.0960.0715
Total 4.70583 8.4704
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying of Drinking Water Pipeline4.705838.4704
Total 4.70583 8.4704
C. Maps of forest land proposed to be diverted
Division 1. : Forest Division Chitrakoot (Karvi)
  (i). Area of forest land proposed to be diverted(in ha.) : 4.70583   (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).
1.4.70583    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): 5000
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 ?: No   (iii). No. of districts involved for raising Compensatory Afforestation: 1   (iv). No. of patches: One
District 1. : Chitrakoot
  (a). Village: Dadri Mafi   (b). Area(in ha.): 4.10208   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 600   (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
1UNDERTAKING FOR CA DEPOSIT
2UNDERTAKING FOR ETT
3IRRIGATION NOC
4UNDERTAKING FOR MINIMUM TREES FELLING
5PWD NOC
6SANCTION LETTER
7STANDARD CONDITIONS
8UNDERTAKING FOR VANYA JEEV VIHAR
9UNDERTAKING FOR NOT START WORK BEFORE FOREST APPROVAL
10FOREST NOTIFICATION
11UNDERTAKING FOR LEASE AMOUNT DEPOSIT
12MUCK DISPOSAL PLAN
13UNDERTAKING FOR NPV DEPOSIT
14VAIKALPIK VAN BHOOMI CERTIFICATE
15AREA CALCULATION SHEET
16LAYOUT PLAN
17UNDERTAKING FOR NO SUBSQUENT PROPOSAL INITIATION
18RAILWAY NOC
19EDS LETTER