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/ROAD/10485/2015   (ii). Name of Project for which Forest Land is required : Construction of Dhaun to Badoli M/R under PMGSY Champawat.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : The proposal has been made for construction of Dhaun to Badoli Motor Road under PMGSY Champawat which shall provide connectivity to villages Badoli with a population of 431. Thus total population being served with this road.   (iv). State : Uttarakhand   (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) : 301   (viii). Area of forest land proposed for diversion(in ha.): 3.36   (ix). Non-forest land required for this project(in ha.): 1.575   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : PMGSY   (ii). Address1 : OFFICE OF THE EXECUTIVE ENGINEER, IRRIGATION DIVISION (P.W.D.)CHAMPAWAT   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Champawat   (vi). Pin : 262523   (vii). Landmark : NEAR POST OFFICE   (viii). Email address : eepmgsychampawat@rediffmail.com   (ix). Landline Telephone No. : 5965-230148   (x). Fax No. : 5965-0   (xi). Mobile No. : 9411521847   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Sanjay   (ii). Middle Name: NIL   (iii). Last Name: Tewari   (iv). Gender: Male   (v). Designation: ASSISTANT ENGINEER   (vi). Address 1: OFFICE OF THE EXECUTIVE ENGINEER, IRRIGATION DIVISION (P.W.D.)CHAMPAWAT   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Champawat   (x). Tehsil: Champawat   (xi). Pin: 262523   (xii). Landmark: NEAR POST OFFICE   (xiii). Email Address: eepmgsychampawat@rediffmail.com   (xiv). Landline Telephone No.: 5965-230148   (xv). Fax No.: NIL   (xvi). Mobile No.: 7534880799   (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.Champawat3.361.575
Total3.361.575
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Champawat3.361.575
Total3.361.575
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Swala0.840.18
2BastiyaGoonth0.420
3Majhera0.630.765
4Badoli1.050.63
5DhyanBhandari0.420
Total 3.36 1.575
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road3.361.225
2muck00.349999999999998
Total 3.36 1.575
C. Maps of forest land proposed to be diverted
Division 1. : Champawat
  (i). Area of forest land proposed to be diverted(in ha.) : 3.36   (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).
1.3.36    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): 0   (iii). Temporary Employment(Number of person-days): 6600
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?: 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. : Champawat
  (a). Village: chhira purvi   (b). Area(in ha.): 6.72   (c). Copy of KML file of the patch:     View File   (d). Khasra details: degraded forest land   (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
1If non-forest or Revenue forest land is required to be provided by User Agency? A Copy of ownership proof and No Objection Certificate
2A short narrative and importance of the project
3Administrative and Financial sanction.
4Administrative and Financial sanction.
5Comperative chart showing statement of both alignment or alternate site explored for the proposed project and reasons for their rejection duly countersigned by DFO.
6Certificate from the DM that no alternative suitable non-forest land is available for the project in question and the demand of the forest land for the project is barest minimum.
7Certificate of felling minimum trees during the project work. .
8Whather project area is a part of National Park or sanctuary and airal distance of the project from National Park or sanctuary signed by DFO.
9No voilation has taken place, FC Act. 1980 reg
10Certificate- work has not been started reg.
11Geologist Report (Govt. approved Geologist
12Certificate by user agency for complying the condition imposed in Standard Condition
13Certificate by user agency for complying the condition imposed in geologist report/Task force recommendation in hill areas
14No historical/monumental or relegeous place will be effected certificate reg.
15Undertakoing regarding no animal will be effected adversely by the project.
16Undertading to provide alternative fuelwood, kerosene or LPG to labours involved in project.
17Benefited villages/Families/Population Certificate.
18Undertaking of payment of NPV, if Hon'ble Supreem Court increses the rates of NPV
19Cost of the forest land and lease rent certificate by DM.
20Certificate of Lease period by user agency.
21Undertaking of user agency to bear the cost for dimarcation work
22others doucment.
23Co-ordinate of Alignment
24Felling of oak Trees
25Objection Reply EDS 07.06.2016
26Letter to Nodal Regarding .shp file
27Letter to Nodal Regarding .shp file and GIS generated files
28Revised Objection Reply EDS 07.06.2016
29Nodal Letter regarding soft copies of GIS map files uploaded on Dated 01-10-16
30Revised Objection Reply EDS 07.06.2016 uploaded on Dated 01-10-16
31Objection Reply ( Letter No 1279/03 pmgsy dated 29.12.2016) of Nodal Letter regarding KML files (uploaded on 29.12.2016)
32Remove of Objection Letter
33Objection removel Letter.
34Objection removal letter
35bar chart
36NPV calculation certificate as per Hon'ble Supreem court /MoEF orders by DF
37ca plantation
38Land schedule (for RF signed by DFO and civil soyam, Van panchayat and private nap land signed by DM)
39felling of trees in rf,civil soyam,vanpanchayat and nap land
40objection removal letter
41Objection removal letter 01-08-2018
42Muck Disposal Scheme
43Objection reply 12-09-2018