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/7000/2014   (ii). Name of Project for which Forest Land is required : Road from Gordhanpura to Kali mati   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of BT Road from Gordhanpura to Kali mati under RRSMP Scheme in 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) : 130.96   (viii). Area of forest land proposed for diversion(in ha.): 2.98   (ix). Non-forest land required for this project(in ha.): 0.386   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : PUBLIC WORKS DEPARTMENT   (ii). Address1 : Office of the Executive engineer PWD Division Shahabad, Bus stand Pin-325217   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Baran   (vi). Pin : 325217   (vii). Landmark : Shahabad Bus Stand   (viii). Email address : kkggbn@gmail.com   (ix). Landline Telephone No. : 7460-262300   (x). Fax No. : NIL   (xi). Mobile No. : 9414442171   (xii). Website (if any) : pwd.rajasthan.gov.in/   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Hari Prasad   (ii). Middle Name: NIL   (iii). Last Name: Meena   (iv). Gender: Male   (v). Designation: Executive engineer   (vi). Address 1: Office of the Executive engineer PWD Division Shahabad, Bus stand Pin-325217   (vii). Address 2: Office of the Executive engineer PWD Division Shahabad, Bus stand Pin-325217   (viii). State: Rajasthan   (ix). District: Baran   (x). Tehsil: NIL   (xi). Pin: 325217   (xii). Landmark: Shahabad Bus Stand   (xiii). Email Address: pwd_shahabad@rediffmail.com   (xiv). Landline Telephone No.: 7460-262300   (xv). Fax No.: NIL   (xvi). Mobile No.: 9414286802   (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
1ReturnedFP/RJ/ROAD/6998/20143.90
2ReturnedFP/RJ/ROAD/7127/20142.950
3ReturnedFP/RJ/ROAD/6983/20140.50
4ReturnedFP/RJ/ROAD/7000/20142.98080
5ReturnedFP/RJ/ROAD/6980/201410
Total 11.3308 0
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.Baran Territorial2.980.386
Total2.980.386
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Baran2.980.386
Total2.980.386
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Gordhanpura2.5740
2Kali mati0.4040.386
Total 2.978 0.386
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Roads2.980.386
Total 2.98 0.386
C. Maps of forest land proposed to be diverted
Division 1. : Baran Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 2.98   (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).
1.2.98    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): 40   (iii). Temporary Employment(Number of person-days): 4000
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?: Yes   (a). Copy of Cost-Benefit analysis:
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? : Yes
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. : Baran
  (a). Village: sorsan bilandi takha   (b). Area(in ha.): 103.4   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 39,41,43,114,115,116,138,149,1175,1173,368   (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
1
2
3allotement
4Bar chart
5certificates
6District level Certificate
7DPR
8FRA
9khasra detail of forest
10REply for EDS
11SDM and Gramsabha proceedings
12Reply of EDS raised
13road kml image
14Alternate land kml image