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/155091/2022   (ii). Name of Project for which Forest Land is required : Diversion of 8.161809 Hectare of Forest Land for laying of Drinking Water Distribution Pipelines (Total KM. 96.30) under Jakhlaun Birdha, Dhorra, Balabehat, Kadesara Kalan and Mau Group of Villages Water Supply Scheme, District- Lalitpur (U.P.)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Due to lack of ground water in Bundelkhand area, the main objective of this Drinking Water PipelineProject is to provide safe and drinking water to People of rural areas of District Lalitpur. In this project the large number of people will be benefitted.   (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) : 39598   (viii). Area of forest land proposed for diversion(in ha.): 8.161809   (ix). Non-forest land required for this project(in ha.): 18.793686   (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 LUCKNOW (UP)   (ii). Address1 : U.P JAL NIGAM PERMISSES, 6 RANA PRATAP MARG,LUCKNOW   (iii). Address2 : NIL   (iv). State : Uttar Pradesh   (v). District : Lucknow   (vi). Pin : 226001   (vii). Landmark : NIL   (viii). Email address : ed.jjmup@rediffmail.com   (ix). Landline Telephone No. : 522-2239428   (x). Fax No. : 522-   (xi). Mobile No. : 9473942754   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Avneesh   (ii). Middle Name: NIL   (iii). Last Name: Singh   (iv). Gender: Male   (v). Designation: Secretary DWSM, Executive Engineer,U P Jal Nigam   (vi). Address 1: Lalitpur   (vii). Address 2: NIL   (viii). State: Uttar Pradesh   (ix). District: Lalitpur   (x). Tehsil: Lalitpur   (xi). Pin: 284403   (xii). Landmark: NIL   (xiii). Email Address: pmjalltp@gmail.com   (xiv). Landline Telephone No.: 0-   (xv). Fax No.: NIL   (xvi). Mobile No.: 9473942768   (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 Lalitpur8.16180918.793686
Total8.16180918.793686
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Lalitpur8.16180918.793686
Total8.16180918.793686
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1AHETA0.2904730.199874
2AMARPUR00.080308
3AMAU KHERA00.119371
4ANDHER00.764896
5BACHHALA PUR00.335857
6BAIDORA00.147542
7BALABEHAT0.2522240.623731
8BAMHORI BANSHA0.0448760.018493
9BAMHORI PATHAR0.0193930.132543
10BAMROLA0.0851520.070419
11BANDAR GURHA0.2763370
12BAND PURA00.17108
13BANGUWAN KALAN0.1726880.064022
14BANT0.1039690.170397
15BARAITHI00.218131
16BARODA BIJLON00.371099
17BHAINSAI0.1154970.016372
18BHONRSIL0.190520.062553
19BHARON0.2864520
20BIGHA KHET0.0690940.063295
21BIGHA MAHAWAT00.14325
22BIJROTHA0.0085910.447857
23BIRARI00.337305
24BIRDHA00.019529
25BUDERO1E-060.241675
26CHIMNA0.0216890
27CHOKA0.0233810
28BUDHENDI00.226524
29CHANDERA00.07705
30DAULTA0.0393360.003484
31DHOJRI0.5303750.0282
32DHORRA0.1607160.497659
33DHOWAN KHERI00.550874
34DHURWARA0.0694970.110758
35DUDHAI0.1855610.293168
36DUNGRIYA0.2363790.004118
37GAUNA RANGE0.1928770.02649
38GHISAULI0.0874710.152902
39GUGAR01.176382
40HANOTIYA0.0178430.026873
41IMILIYA00.029758
42JAHAJ PURA00.130789
43JAKHALON0.2257950.436713
44JAMUNDHANA KALAN00.252867
45JHILGUWAN0.0887780.022502
46KACHNODA KALAN00.370592
47KADESRA KALAN0.4828471.588102
48KHADOWARA00.337336
49KANPURA0.1182050
50KAPASI0.4988110
51KHANDI0.7535331.881197
52KUCHDON0.1018740
53KHOKHRA00.237584
54KUMROLA00.140859
55LAKHAN PUR0.0228110.051451
56LALITPUR RANGE0.2981550.39072
57LIDHORA00.101697
58MADAUNA0.0020980
59MADON0.1140660
60MAGAR PUR00.645319
61MAHARRA0.1012370.045866
62MANIKCHOK0.2207120
63MAU00.382391
64MIYAO00.309517
65MUDNARI0.187340.274567
66MUKTORA00.09438
67NADAN WARA0.0798730.03536
68NIWAUWA00.326956
69PACHAUNI00.36619
70PALI RURAL0.1235470.075144
71PATHARAI0.0014710.309232
72PATHARA0.0856220
73PATHARI00.240159
74PIPARIYA JAGIR0.1993080.013114
75PYAU0.0440430
76RAJORA00.11147
77RAJPUR0.1275720.451389
78RAJWARA00.248382
79RAMPURA0.0615960
80RASOI0.1308890.079117
81SEPURA MUNJAFTA0.2375280
82SARA00.351087
83SIMARDHA0.0777860.015741
84SMHASA00.065046
85SUKHPURA0.125010
86TARGUWAN0.0512730.0972
87THANA0.1196370.105479
88TIKRA TIWARI00.0173
89VIJAYPURA00.167032
Total 8.161809 18.793686
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying of Drinking Water Distribution Pipeline8.16180914.858481
2INTAKES00.120429
3OVER HEAD TANKS (OHT)03.814776
Total 8.161809 18.793686
C. Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Lalitpur
  (i). Area of forest land proposed to be diverted(in ha.) : 8.161809   (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).
1.8.161809    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): 2000
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?: 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.): 4.04   (c). Area of non-forest or Revenue forest land required to be provided by User Agency for raising Compensatory Afforestation(in ha.): 6.14   (iii). No. of districts involved for raising Compensatory Afforestation: 1   (iv). No. of patches: One
District 1. : Lalitpur
  (a). Village: Kari pahadi   (b). Area(in ha.): 6.14   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 192/4   (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
1FOREST GAZETTE
2PROJECT SANCTION LETTER
3UNDERTAKING FOR NO SUBSEQUENT PROPOSAL INITIATED FOR THE SAME AREA
4CERTIFICATE FOR LEASE PERIOD
5UNDERTAKING FOR MINIMUM TREES TO BE FELLED
6UNDERTAKING FOR ETT
7UNDERTAKING FOR NOC OF OWNER DEPARTMENT
8UNDERTAKING FOR NON STARTING OF ANY ACTIVITY WITHOUT SANCTION FROM COMPETENT AUTHORITY
9MUCK DISPOSAL PLAN
10UNDERTAKING FOR PAYMENT OF CA
11UNDERTAKING FOR PAYMENT OF NPV
12UNDERTAKING REGARDING CERTIFICATE UNDER FRA
13JUSTIFICATION FOR USE OF FOREST LAND
14AREA CALCULATION SHEET
15UNDERTAKING FOR PAYMENT OF LEASE PREMIUM AND LEASE RENT
16COMPLETE PLAN OF WATER SUPPLY SCHEME
17COMPONENTWIE BREAKUP OF LAND
18RECIEPT OF SUBMISSION OF HARD COPY AT DFO OFFICE
19NOC of NHAI
20Regarding Providing Equivalent Non forest Land identification
21Khatauni of Equivalent non forest land of village Kari Pahadi