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/13768/2015   (ii). Name of Project for which Forest Land is required : ITJSK PACKAGE2 DRINKING WATER PROJECT   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : “Laying of Pipeline and Construction of ESR under Integrated Taranagar – Jhunjhunu - Sikar Drinking Water Supply Project, PKG-II-Jhunjhunu (Rajasthan)”   (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) : 43600   (viii). Area of forest land proposed for diversion(in ha.): 0.5662   (ix). Non-forest land required for this project(in ha.): 20.887   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : PHED ITJSK PROJECT PACKAGE II   (ii). Address1 : se phed projectjhunjhunu near jb shah college mandawa mod meghwal complex third floor jhunjhunu-333001   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : jhunjhunu   (vi). Pin : 333001   (vii). Landmark : mandawa mode   (viii). Email address : seprojectcirclejjn@gmail.com   (ix). Landline Telephone No. : 159-2230110   (x). Fax No. : 159-   (xi). Mobile No. : 9414053739   (xii). Website (if any) : none   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: BHARAT   (ii). Middle Name: LAL   (iii). Last Name: MEENA   (iv). Gender: Male   (v). Designation: SE   (vi). Address 1: se phed projectjhunjhunu near jb shah college mandawa mod meghwal complex third floor jhunjhunu-333001   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: jhunjhunu   (x). Tehsil: Sayla   (xi). Pin: 333001   (xii). Landmark: mandawa mode   (xiii). Email Address: seprojectcirclejjn@gmail.com   (xiv). Landline Telephone No.: 159-2230110   (xv). Fax No.: NIL   (xvi). Mobile No.: 7665438377   (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.Jhunjhunu Territorial0.566220.887
Total0.566220.887
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Jhunjhunu0.566220.887
Total0.566220.887
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Tateeja0.04770.43
2Basant Bihar0.0180.213
3Kalota0.02530.445
4Mandana0.04780.5589
5Dhani Dhima0.07340.189
6Papurana0.03690.3926
7Rajota0.0610.18
8Chirani0.1240.1471
9Badalwas0.01430.3734
10Tyonda0.05690.2563
11Sihor0.06090.2377
12Remaining Non forest Village as per attached list017.46
Total 0.5662 20.883
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying of Pipeline0.503720.887
2Overhead tank0.06250
Total 0.5662 20.887
C. Maps of forest land proposed to be diverted
Division 1. : Jhunjhunu Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.5662   (ii). Nature of the Project: Non Linear   (a). No. of patches : Two
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.
1.0.0625    View File
2.0.5037    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): 5   (iii). Temporary Employment(Number of person-days): 1500
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? : 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
1AUTHORIZATION LETTER
2Administration and Financial Sanction
3COST BENEFIT ANALYSIS
4JAMABANDI NAKAL
5PERMISSION FOR PWD NOC
6Technical Sanction.
7JUSTIFICATION FOR LOCATING PROJECT IN FOREST AREA.
8Undertaking for FRA Certificate.
9Undertaking for Use of Any Material From Forest Land.
10UNDERTAKING FOR CONSERVATION OF FLORA FAUNA DURING LAYING OF PIPELINE.
11UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED FOREST LAND.
12UNDERTAKING FOR NO OTHER FEASIBLE ALTERNATIVE AND DIVERSION OF MINIMUM FOREST LAND.
13UNDERTAKING FOR PAYMENT OF ANY OTHER COST AND CONDITION.
14UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION.
15UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA.
16UNDERTAKING FOR USE OF FOREST LAND.
17Undertaking for Waste Management.
18Khasra Map and jamabandi.
19Digital Map.
20Google Map.
21Toposheet Map.
22Revised Area Calculation Sheet.
23Bar Chart Status of Jhunjhunu Water Supply Scheme.