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/RJ/ROAD/30812/2017   (ii). Name of Project for which Forest Land is required : Diversion of Construction for Mandalgarh -Goth Link Road 0.836163 ha.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diversion of Construction for Mandalgarh -Goth Link Road (chainage 00/00 to 3/975) 0.836163 ha.,This road is very Important Mandalgarh town to Goth , Tehsil -Mandalgarh,District - Bhilwara, Rajasthan   (iv). State : Rajasthan   (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) : 278   (viii). Area of forest land proposed for diversion(in ha.): 0.836163   (ix). Non-forest land required for this project(in ha.): 0.487512   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : NAGAR PALIKA MANDALGARH   (ii). Address1 : NAGAR PALIKA OFFICE MANDALGARH,NEAR BUS STAND,MANDALGARH,DISTRICT BHILAWARA   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Bhilwara   (vi). Pin : 311604   (vii). Landmark : BUS STAND   (viii). Email address : npmandalgarh@gmail.com   (ix). Landline Telephone No. : 1489-230036   (x). Fax No. : 1489-   (xi). Mobile No. : 9166155860   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: SABIR   (ii). Middle Name: NIL   (iii). Last Name: HUSSAIN   (iv). Gender: Male   (v). Designation: EXECUTIVEOFFICER   (vi). Address 1: NAGAR PALIKA OFFICE MANDALGARH,NEAR BUS STAND,MANDALGARH,BHILWARA RAJASTHAN   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Bhilwara   (x). Tehsil: Mandalgarh   (xi). Pin: 311604   (xii). Landmark: BUS STAND   (xiii). Email Address: npmandalgarh@gmail.com   (xiv). Landline Telephone No.: 1489-230036   (xv). Fax No.: NIL   (xvi). Mobile No.: 9166155860   (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.Bhilwara Territorial0.8361630.487512
Total0.8361630.487512
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bhilwara0.8361630.487512
Total0.8361630.487512
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Mandalgarh0.7462530.127206
2Khachrol0.089910.360306
Total 0.836163 0.487512
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Mandalgarh to Goth chainage no 00 to 39750.8361630.487512
Total 0.836163 0.487512
C. Maps of forest land proposed to be diverted
Division 1. : Bhilwara Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.836163   (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).
1.0.836163    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: 1.This is the prevailing route. 2. This route is
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 20   (iii). Temporary Employment(Number of person-days): 4500
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?: 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
1ADMINISTRATIVE & FINANCIAL SANCTION
2Area Calculation Mandalgarh-Goth Link Road
3Authorization Letter
4BAR CHART
5EASTMATE
6CERTIFICATE FOR MINIMUM USE OF FOREST LAND
7JAMABANDI
8KHASRA MAP
9Justification For Locating Project
10CROSS SECTION ROAD
11FRA CERTIFICATE
12NAGAR PALIKA EMPAWORD MEETING COPY
13STATEMENT SHOWING DETAILS OF FOREST AREA PROPOSED FOR DIVERSION
14UNDERTAKING FOR CONSERVATION OF FLORA-FAUNA DURING CONSTRUCTION OF ROAD
15UNDERTAKING FOR NO CHANGE’S IN STATUTORY POSITION OF DIVERTED FOREST LAND
16UNDERTAKING FOR NO OTHER FEASIBLE ALTERNATIVE & DIVERSION OF MINIMUM FOREST LAND
17UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION
18UNDERTAKING FOR PAYMENT OF ANY OTHER COST AND CONDITION
19UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA
20UNDERTAKING FOR USE OF ANY MATERIAL FROM SURROUNDED FOREST LAND DURING CONSTRUCTION OF ROAD
21UNDERTAKING FOR USE OF FOREST LAND
22UNDERTAKING FOR WASTE MANAGEMENT DURING CONSTRUCTION ACTIVITY
23MAP SHOWING FOR GEO-REFERANCED SURVEY OF INDIA TOPOSHEET WITH FOREST BOUNDARY AND PROPOSED ROAD ALIGNMENT
24Digital Map
25Google Imagry Map