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/40626/2019   (ii). Name of Project for which Forest Land is required : Reorganisation of Urban Water Supply Scheme Jodhpur (AFD France Funded Project)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The proposal is for laying of drinking water under ground pipeline in forest area (316 M) near Minaka Nadi, Out side Chandpol Jodhpur. The pipeline shall be laid along the existing track.   (iv). State : Rajasthan   (v). Category of the Proposal : Drinking Water   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 74050   (viii). Area of forest land proposed for diversion(in ha.): 0.0316   (ix). Non-forest land required for this project(in ha.): 0.0284   (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 HEALTH ENGINEERING DEPARTMENT   (ii). Address1 : Executive Engineer PHED Project Division V Jodhpur   (iii). Address2 : NIL   (iv). State : Rajasthan   (v). District : Jodhpur   (vi). Pin : 342005   (vii). Landmark : KRISHI MANDI TURN, PALI ROAD   (viii). Email address : eeproject05@gmail.com   (ix). Landline Telephone No. : 291-2651755   (x). Fax No. : 291-   (xi). Mobile No. : 9414219035   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Shaitan   (ii). Middle Name: Mal   (iii). Last Name: Suthar   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: PHED Project Division V Jodhpur   (vii). Address 2: NIL   (viii). State: Rajasthan   (ix). District: Jodhpur   (x). Tehsil: Jodhpur   (xi). Pin: 342005   (xii). Landmark: KRISHI MANDI TURN, PALI ROAD   (xiii). Email Address: eeproject05@gmail.com   (xiv). Landline Telephone No.: 291-2651755   (xv). Fax No.: NIL   (xvi). Mobile No.: 9414498523   (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.Jodhpur Territorial0.03160.0284
Total0.03160.0284
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Jodhpur0.03160.0284
Total0.03160.0284
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Banga0.03160.0284
Total 0.0316 0.0284
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying of 400 mm Dia DI Drinking Water Supply Pipe0.03160.0284
Total 0.0316 0.0284
C. Maps of forest land proposed to be diverted
Division 1. : Jodhpur Territorial
  (i). Area of forest land proposed to be diverted(in ha.) : 0.0316   (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).
1.0.0316    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: Pipeline is Proposed along the existing Road.
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 0   (iii). Temporary Employment(Number of person-days): 100
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 and Financial Approval.
2Brief Note of The Project.
3JUSTIFICATION FOR LOCATING PROJECT IN FOREST AREA.
4CERTIFICATE FOR MINIMUM USE OF FOREST LAND.
5UNDERTAKING FOR CONSERVATION OF FLORA FAUNA DURING LAYING OF PIPELINE.
6UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED FOREST LAND.
7UNDERTAKING FOR NO OTHER FEASIBLE ALTERNATIVE MINIMUM FOREST LAND.
8UNDERTAKING FOR PAYMENT OF ANY OTHER COST AND CONDITION.
9UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION.
10UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA.
11Undertaking for Use of Any Material From Forest Land.
12UNDERTAKING FOR USE OF FOREST LAND.
13Undertaking for Waste Management.
14Reply Letter of 05 August 2019 EDS.
15Bar Chart Status.
16Typical Cross Section.
17Digital Map of Required Forest Land.
18Zoom View Digital Map of Required Forest Land.
19Zoom View Toposheet Map.
20Survey Of India Full Toposheet Map.
21Reply Letter of 13 December 2019 EDS.
22Area Calculation Sheet.
23Khasra Map and Jamabandi Nakal.
24Reply Letter of 17 Jan 2020 EDS.
25Reply Letter of 01.04.2020 EDS.