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/48584/2020
(ii). Name of Project for which Forest Land is required :
Construction of Approach Road for Proposed Hindustan Petroleum Corp. Ltd. Retail Outlet on Barmer City - Dhorimanna Road (NH-68) between KM Stone No. 163-164 (Chainage: 163/616 - 163/576) RHS in Khasra No. 2466/699, At Village -Mahabar Peethal, Tehsil - Barmer, District - Barmer, Raj
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
Construction of Approach Road for Proposed Hindustan Petroleum Corp. Ltd. Retail Outlet on Barmer City - Dhorimanna Road (NH-68) between KM Stone No. 163-164 (Chainage: 163/616 - 163/576) RHS in Khasra No. 2466/699, At Village -Mahabar Peethal, Tehsil - Barmer, District - Barmer, Raj
(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) :
45
(viii). Area of forest land proposed for diversion(in ha.):
0.1962
(ix). Non-forest land required for this project(in ha.):
0.2012
(x). Total period for which the forest land is proposed to be diverted(in years):
19.90
A-2.
Details of User Agency
(i). Name :
HINDUSTAN PETROLEUM CORPORATION LTD JODHPUR
(ii). Address1 :
HPCL JODHPUR
(iii). Address2 :
Retail Regional Office, Jodhpur
(iv). State :
Rajasthan
(v). District :
Jodhpur
(vi). Pin :
342005
(vii). Landmark :
NIL
(viii). Email address :
hpclgudiya@gmail.com
(ix). Landline Telephone No. :
2931-2989210
(x). Fax No. :
2931-
(xi). Mobile No. :
9414747664
(xii). Website (if any) :
NIL
(xiii). Legal status of User Agency :
Central PSU
A-3.
Details of Person Making Application
(i). First Name:
Krishan
(ii). Middle Name:
NIL
(iii). Last Name:
Lal
(iv). Gender:
Male
(v). Designation:
Dy. General Manager
(vi). Address 1:
HPCL, Jodhpur
(vii). Address 2:
Retail Regional Office, Jodhpur
(viii). State:
Rajasthan
(ix). District:
Jodhpur
(x). Tehsil:
NIL
(xi). Pin:
342005
(xii). Landmark:
NIL
(xiii). Email Address:
hpclgudiya@gmail.com
(xiv). Landline Telephone No.:
2931-2989210
(xv). Fax No.:
NIL
(xvi). Mobile No.:
9414747664
(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
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
1
Approved
FP/RJ/ROAD/25888/2017
F.1(46)Forest/2018
0.1421
0.1421
09 Aug 2018
05 Mar 2019
Total
0.1421
0.1421
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.
Barmer Territorial
0.1962
0.2012
Total
0.1962
0.2012
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Barmer
0.1962
0.2012
Total
0.1962
0.2012
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
Mahabar Peethal
0.1962
0.2012
Total
0.1962
0.2012
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Construction of Approach Road Deceleration Lane LH
0.0581
0.0206
2
Construction of Approach Road Acceleration Lane RH
0.0953
0.0206
3
Front Side Service Road
0.0428
0
4
outlet Area
0
0.16
Total
0.1962
0.2012
C.
Maps of forest land proposed to be diverted
Division 1. : Barmer Territorial
(i). Area of forest land proposed to be diverted(in ha.) :
0.1962
(ii). Nature of the Project:
Linear
(b). No. of Segments :
Three
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.
0.0581
View File
2.
0.0953
View File
3.
0.0428
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
E.
Employment likely to be generated
(i). Whether the Project is likely to generate employment ?:
Yes
(ii). Permanent/Regular Employment(Number of persons):
9
(iii). Temporary Employment(Number of person-days):
250
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
1
CERTIFICATE FOR MINIMUM USE OF FOREST LAND.
2
Details of Permanent Employment to be generated.
3
UNDERTAKING FOR CONSERVATION OF FLORA FAUNA DURING.
4
UNDERTAKING FOR FRA CERTIFICATE.
5
UNDERTAKING FOR HIGH TENSION LINE.
6
UNDERTAKING FOR LP GAS GODOWN.
7
UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED FOREST LAND.
8
UNDERTAKING FOR NO OTHER FEASIBLE ALTERNATIVE MINIMUM FOREST LAND.
9
UNDERTAKING FOR PAYMENT OF ANY OTHER COST and CONDITION.
10
UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION.
11
UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA.
12
Undertaking for Use of Any Material From Forest Land During Construction.
13
UNDERTAKING FOR USE OF FOREST LAND.
14
Undertaking for Waste Management.
15
Area Calculation Sheet.
16
Approved Layout Plan.
17
Geo Referenced Digital Map with Coordinates.
18
Geo Referenced Toposheet map 50000 scale.
19
Geo Referenced Full Toposheet map 50000 scale 40O6.
20
Land Conversion Letter.
21
LOI Letter.
22
Morth NOC.
23
Project Report.
24
Khasra map and Jamabandi.
25
Bar Chart Status.
26
EDS Reply Dated 16_09_2020.
27
Layout Plan with Area Calculation.
28
Nearest Existing Retail Outlet Distance Certificate.
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