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/WATER/10622/2015   (ii). Name of Project for which Forest Land is required : water supply and sewerage project in Tonk town under RUIDP Phase III   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Work of Water Supply Distribution Network Improvement with house service connections for Non Revenue Water reduction and continuous water supply and providing Sewer Network with house connections, construction of Sewage Treatment Plant & allied works and Operation Services of the entire system for 1   (iv). State : Rajasthan   (v). Category of the Proposal : Drinking Water   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 41500   (viii). Area of forest land proposed for diversion(in ha.): 0.1435   (ix). Non-forest land required for this project(in ha.): 0   (x). Total period for which the forest land is proposed to be diverted(in years): 100
A-2. Details of User Agency
  (i). Name : PHED   (ii). Address1 : PHED Campus, Civil Lines, Tonk   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Tonk   (vi). Pin : 304001   (vii). Landmark : Civil Lines   (viii). Email address : phedtonk@rediffmail.com   (ix). Landline Telephone No. : 1432-248009   (x). Fax No. : 1432-248009   (xi). Mobile No. : 3414038978   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Rajesh   (ii). Middle Name: Kumar   (iii). Last Name: Goyal   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: PHED Campus, Civil Lines, Tonk   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Tonk   (x). Tehsil: Tonk   (xi). Pin: 304001   (xii). Landmark: Civil Lines   (xiii). Email Address: phedtonk@rediffmail.com   (xiv). Landline Telephone No.: 1432-248009   (xv). Fax No.: 01432248009   (xvi). Mobile No.: 9414038978   (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.Tonk Territorial0.14350
Total0.14350
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Tonk0.14350
Total0.14350
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Tonk Sharki0.14350
Total 0.1435 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1OHSR, Rising Main & Distribution main0.14350
Total 0.1435 0
C. Maps of forest land proposed to be diverted
Division 1. : Tonk Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.1435   (ii). Nature of the Project: Non Linear   (a). No. of patches : One
Patch wise details
Patch No. Area of Patch(in ha.) Kml File of PatchesTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0.1435    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:
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): 100000
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
1NPV Certificate
2Purpose wise (for OHSR, pipe line) detail of forest land required
3Undertaking on stamp paper
4detail of water supply related works sanctioned for city Tonk under project
5Approval letter for diversion of forest land to PHED issued earlier for other projects in Tonk
6Detail of Forest and Non Forest land required for various works under project
7Brief Summary of the sanctioned Project for Tonk
8Administrative & Financial Sanction order of the Project for Tonk
9Technical Sanction order of the Project for Tonk
10Jamabandi and khasra map of forest land as per revenue record
11reply of observation sent earlier on dated 23.06.2015 in reference to Essential details sought by forest department on dated 16.03.2015
12A map showing the source of water (Bisalpur dam)to Tonk system in reference to EDS point no. 10
13Map showing the detail of sewerage works sanction for Tonk
14Map showing the detail of sewerage works sanction for Tonk
15Map showing the detail of water supply works sanction for Tonk
16Schedule of execution of sanctioned works under project
17Minimum Need Certificate
18Signed Map prepared using Total Station showing the latitude & longitude of the proposed land along with Forest Boundary
19Topo Sheet (GT Sheet on scale 1:50000) showing OHSR location, proposed pipeline detail, forest boundary etc.
20Reply dated 10.09.2015 for observations of 26.08.2015.