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/42084/2019   (ii). Name of Project for which Forest Land is required : New Construction of Patharkhani to Selkatiya, Dubaliya, Vijurkanda, Dhuira Motor Road   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Consttruction of Patharkhani to Selkatiya, Dubaliya, Dhuira and vijurkanda started from km 13.00 of Aincholi Barabey M/R and goes to Dhuira village. More then 250 people benefited by this road. This project made easy life of habitation and helpful for development of villages passing through this roa   (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) : 233.1   (viii). Area of forest land proposed for diversion(in ha.): 0.847   (ix). Non-forest land required for this project(in ha.): 3.203   (x). Total period for which the forest land is proposed to be diverted(in years): 100
A-2. Details of User Agency
  (i). Name : PUBLIC WORK DEPARTMENT   (ii). Address1 : PD PWD PITHORAGARH GHANTAKARAN DISTT PITHORAGARH 262501   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Pithoragarh   (vi). Pin : 262501   (vii). Landmark : NEAR POST OFFICE   (viii). Email address : harishbathyal99@gmail.com   (ix). Landline Telephone No. : 5964-225115   (x). Fax No. : 5964-225115   (xi). Mobile No. : 9412144099   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Sunil   (ii). Middle Name: Kumar   (iii). Last Name: Kohali   (iv). Gender: Male   (v). Designation: EXECUTIVE ENGINEER   (vi). Address 1: PD PWD PITHORAGARH GHANTAKARAN DISTT PITHORAGARH 262501   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Pithoragarh   (x). Tehsil: Pithoragarh   (xi). Pin: 262501   (xii). Landmark: NEAR POST OFFICE   (xiii). Email Address: pwdpithoragarh@gmail.com   (xiv). Landline Telephone No.: 5964-225115   (xv). Fax No.: 05964225115   (xvi). Mobile No.: 9412144099   (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.Pithoragarh0.8473.203
Total0.8473.203
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Pithoragarh0.8473.203
Total0.8473.203
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Selkatiya0.180.7875
2Dubaliya0.530.3599
3Vijurkanda0.071.17
4Patharkhani0.0670.8856
Total 0.847 3.203
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road0.7653.203
2Muck Dumping0.0820
Total 0.847 3.203
C. Maps of forest land proposed to be diverted
Division 1. : Pithoragarh
  (i). Area of forest land proposed to be diverted(in ha.) : 0.847   (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).
1.0.847    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): 28689
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
4Comperative Chart
5Certificate from The DM that no alternate suitable non forest land is available for the project
6Land Schedule
7Category wise land length, width and area
8Bar Chart
9Certificate regarding suitability of identified land for CA
10Road side gap filling plantation Undertaking
11Felling of Oak trees
12If felling of trees is not involved certificate by dfo
13If felling of trees is not involved certificate by dfo
14Certificate of felling minimum tress
15Muck Disposal Scheme
16Arial distance certificate .. the distance measure from Askot National Park.
17If the project area is within 10km radius of national park N/P or sanctuary, certificate of CCF wildlife
18If the project falling within the national park or sanctuary , needs recommandation of NBWL
19No voilation taken place , FC act 1980
20NOC from local Gram Sabhas
21Certificate work has not been started
22Geologist Report
23Task Force Report
24Certificate by User Agency for complying the condition imposed in standard condition
25Certificate by user agency for complying the condition imposed in geologist report
26No historical / Monumental or religeous place will be effected
27Undertaking regarding no animal will be effected
28Undertaking to provide alternative fuelwood, kerosene or LPG to labours
29Benefited villagers/ families/ population certificate
30NPV calculation certificate
31Undertaking of payment of NPV
32Cost of the forest land and lease rent certificate by DM
33Certificate of lease period by agency
34Undertaking of user agency to bear the cost of demarcation work
35perfoma 2
36perfoma3
37Hard copy of the proposal submission letter
38objection removed pointwise
39all objection removed
40objection removed pointwise 20 apr
41hard copy submission letter