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/16996/2015   (ii). Name of Project for which Forest Land is required : Construction of Jalna to TRC Toli Motor Road.(length-3.00KM)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction of Jalna to TRC Toli Motor Road (3.00km)in jageshawar constituency,Distt Almora.Construction of Jalna to TRC toli is proposed as a extension of almora shaharphatak motor road the sention lenth of proposed motor road is 3.00 km. The benifited village of this Road are. Talli Toli and Mall   (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) : 198.99   (viii). Area of forest land proposed for diversion(in ha.): 0.858   (ix). Non-forest land required for this project(in ha.): 1.992   (x). Total period for which the forest land is proposed to be diverted(in years): 1000
A-2. Details of User Agency
  (i). Name : EXECUTIVE ENGINEER   (ii). Address1 : Provincial Division P.W.D., Almora   (iii). Address2 : Mall Raod Almora   (iv). State : Uttarakhand   (v). District : Almora   (vi). Pin : 263601   (vii). Landmark : Chaughan Pata, Almora   (viii). Email address : eepdalmora@rediffmail.com   (ix). Landline Telephone No. : 5962-2320033   (x). Fax No. : 5962-5962   (xi). Mobile No. : 7533877888   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Indrajit   (ii). Middle Name: NIL   (iii). Last Name: Bose   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Executive Engineer, Provincial Division, Public works Department, Almora   (vii). Address 2: Mall Road Almora   (viii). State: Uttarakhand   (ix). District: Almora   (x). Tehsil: Almora   (xi). Pin: 263601   (xii). Landmark: Chaughan Pata, Almora   (xiii). Email Address: eepdalmora@rediffmail.com   (xiv). Landline Telephone No.: 5962-230033   (xv). Fax No.: 059622320033   (xvi). Mobile No.: 9410159182   (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.Civil Soyam,Almora0.8581.992
Total0.8581.992
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Almora0.8581.992
Total0.8581.992
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Talli toli0.3431
2Malli toli0.3650.992
3Muck Disposal(Malli toli)0.050
4Muck Disposal(Talli toli)0.10
Total 0.858 1.992
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1muck Disposal0.150
2motor Road0.7081.992
Total 0.858 1.992
C. Maps of forest land proposed to be diverted
Division 1. : Civil Soyam,Almora
  (i). Area of forest land proposed to be diverted(in ha.) : 0.858   (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).
1.0.858    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): 1   (iii). Temporary Employment(Number of person-days): 4
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
1A short narrative and importance of the project..
2Administrative and Financial sanction
3Preliminary Joint Inspection report (by user agency, forest department, revenue department etc.)
4site explored for the proposed project and reasons for Comparative chart showing statement of both alignment or alternate their rejection duly countersigned by DFO
5Certificate 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
6Land schedule (for RF signed by DFO and civil soyam, Van panchayat and private nap land signed by DM).
7Category wise (RF,civil soyam, Van panchayat and private nap land, Notified forest land etc.) land length, width and area in Ha.
8Bar Chart with index (counter signed by DFO).
9Compensatory afforestation scheme in Civil and Soyam land (10 years) by DFO
10Certificate Regarding. suitability of indentified land for Compensatory Aforestation by DFO
11Undertaking by the User Agency to bear the cost of compensatory aforestation duly counter signed by the DFO
12Road side/gap filling plantation estimate (by DFO)
13Undertaking by the User Agency to bear the cost of Road side /gap filling plantation (by user agency)
14Estimate of 100 trees plantation by DFO ( less then 1.0 ha. cases )
15Details of the trees with their scientific name in RF, Civil Soyam, Van Panchayat, Private Notified land and in Nap Land should be mentioned (with valuation of the trees to be felled ) (0-10 dia trees will be mentioned as saplings). (pdf file) Tree count
16Felling of Oak trees (if involves, inspection report of the concerning CF has to be provided).
17If felling of trees is not involved, certificate by DFO in this regard.
18Certificate of felling minimum trees during the project work.
19Whather project area is a part of National Park or sanctuary and aural distance of the project from National Park or sanctuary signed by DFO.
20If the project area is within 10 Km radius of N/P or Centaury, Comments/No objection certificate of CCF Wild Life has to be provided.
21If the Project falling within the National park or Sanctuary, needs recommendation of State Wild Life Board, National Board of Wild Life (NBWL) and permission of Hon'ble Supreme Court/MoEF GoI
22No violation has taken place, FC Act. 1980 reg.
23NOC from local Gram Sabhas.
24Approved general lay out plan/alignment and estimate from competent authority with name and designation
25Component wise details of construction work.
26Certificate- work has not been started reg.
27Geologist Report (Govt. approved Geologist).
28Task Force report
29Item wise details of works.
30Certificate by user agency for complying the condition imposed in Manak Shartain
31Certificate by user agency for complying the condition imposed in geologist report/Task force recommendation in hill areas (excluding drinking water
32No historical/monumental or religious place will be effected certificate reg. (by DM/DFO)
33Undertaking regarding no animal will be effected adversely by the project.
34Undertaking to provide alternative fuel wood, kerosene or LPG to labours involved in project
35Benefited villages/Families/Population Certificate.
36NPV calculation certificate as per Hon'ble Supreme court /MoEF orders by DFO
37Undertaking of payment of NPV, if Hon'ble Supreme Court increases the rates of NPV (by user agency)
38Cost of the forest land and lease rent certificate by DM.
39Certificate of Lease period by user agency
40Demarcation of land to be diverted
41Undertaking of user agency to bear the cost for demarcation work
42Non-availability of non-forest land for compensatory afforastation certificate by Chief secretary
43Check list/Fact sheet
44As per instruction objection removed
45Muck disposal scheme (in prescribed format)
46EDS Dt 01.09.2016
47Joint Inspection report
48EDS 06.06.2017
49EDS Dt 05.09.2017
50eds 05-11-2017