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/UK/OFC/36899/2018   (ii). Name of Project for which Forest Land is required : Bageshwar OFC (Bageshwar-Kameri Devi)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Reliance Jio is Laying Optical Fiber Cable (OFC) To Provide Mobile Telecom and 4G Internet sevices. Jio will lay underground OFC cables along the hillside on state and national highways to connect to towers in the city / villages that will relay signals in Bageshwar-Kameri Devi in Bageshwar Distric   (iv). State : Uttarakhand   (v). Category of the Proposal : Optical Fibre Cable   (vi). Shape of forest land proposed to be diverted : Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 230   (viii). Area of forest land proposed for diversion(in ha.): 0.265   (ix). Non-forest land required for this project(in ha.): 0.135   (x). Total period for which the forest land is proposed to be diverted(in years): 30
A-2. Details of User Agency
  (i). Name : RELIANCE JIO   (ii). Address1 : Plot no 32, IT Park   (iii). Address2 : sahastradhara road dehradun   (iv). State : Uttarakhand   (v). District : Dehradun   (vi). Pin : 248001   (vii). Landmark : IT park   (viii). Email address : tarit.mohan@ril.com   (ix). Landline Telephone No. : 135-6134219   (x). Fax No. : 135-   (xi). Mobile No. : 9149361424   (xii). Website (if any) : www.jio.com   (xiii). Legal status of User Agency : Private
A-3. Details of Person Making Application
  (i). First Name: Deepak   (ii). Middle Name: Pal   (iii). Last Name: Singh   (iv). Gender: Male   (v). Designation: SCO   (vi). Address 1: Reliance Megamart, GMS Road, Dehradun   (vii). Address 2: uttrakhand   (viii). State: Uttarakhand   (ix). District: Dehradun   (x). Tehsil: NIL   (xi). Pin: 248001   (xii). Landmark: Near Kamla Palace Hotel   (xiii). Email Address: pankaj35.singh@ril.com   (xiv). Landline Telephone No.: 941-2056330   (xv). Fax No.: NIL   (xvi). Mobile No.: 9781535435   (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.Bageshwar0.2650.135
Total0.2650.135
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bageshwar0.2650.135
Total0.2650.135
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Dikra0.0040.003
2Namtichetabagar0.0060.004
3Mandalsera0.0040.002
4Faltniya0.0060.002
5Chhati0.0070.005
6Basai0.0050.003
7Baset0.0050.002
8Mankot0.0040.003
9Burghuna0.0040.004
10siroli0.0050.006
11Kunara0.0060.004
12Dewali Gunth0.0070.004
13Simyal0.0050.003
14Kunera0.0040.002
15Rajoli0.0060.004
16Taknar0.0050.003
17Bijepur0.0060.004
18Thala0.0080.004
19Deo Toli0.050.02
20simraru0.0290.028
21julkiya0.0280.02
22matiyoli0.0270.002
23Kapalkhet0.020.001
24Dura0.0140.002
Total 0.265 0.135
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Laying Of Optical Fiber Cable0.2650.135
Total 0.265 0.135
C. Maps of forest land proposed to be diverted
Division 1. : Bageshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 0.265   (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).
1.0.265    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 other alternative found after examined the loca
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 30   (iii). Temporary Employment(Number of person-days): 20
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 Guidelines By Law.
2FRA GO From Govt. OF Telangana HOFF.
3Power Of Attorney For Signing Authority.
4IP Licence
5Area Tabular Sheet/Land Schedule.
6Indian Telegraph By Law.
7Certificate Of Registration By RJIL.
8Layout & Procedure For Laying Of OFC.
9OFC Layout Sketch.
10CG Forest Permission Dfo Letter.
11Forest Sec Letter.
12Nodal Letter Recv.
13Noc Pwd Permission.
14area calculation sheet
15Land Schedule
16NPV cetificate
17brief detail aboy project -Prapatra 1
18administrative & Financial acceptance- Prarup -5
19BAR Chart Prarup -17
20Non availability of other land - Prapatr -14
21length & Breadth of project Prarup-16
22Work not started certificate Prarup-18
23No tree feeling certificate Prarup-19
24Area not part of National Park certificate Prarup-25.1
25Geologist report not required certificate Prarup-33
26Geologist/ Task force order to be followed- certificate Prarup-34
27Religious/historical place certificate Prarup-37
28No harm to animals declaration certificate Prarup-38
29No use of kerosene & gas declaration Prarup-39
30value of forest land certificate Prarup-41
31Lease period certificate Prarup-41.1
32Disposal of debris Prarup-49
33NPV calculation Prarup-50
34Aerial Distance from National Park
35EDS reply 31-72019