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/8291/2014   (ii). Name of Project for which Forest Land is required : JAJURALI TO SHAHID KISHAN SINGH VILLAGE ROAD   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : JAJURALI TO SHAHID KISHAN SINGH VILLAGE 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) : 37.8   (viii). Area of forest land proposed for diversion(in ha.): 1.71   (ix). Non-forest land required for this project(in ha.): 0.99   (x). Total period for which the forest land is proposed to be diverted(in years): 1
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.Pithoragarh1.710.99
Total1.710.99
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Pithoragarh1.710.99
Total1.710.99
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1JAJURALI1.710.99
Total 1.71 0.99
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1JAJURALI1.710.99
Total 1.71 0.99
C. Maps of forest land proposed to be diverted
Division 1. : Pithoragarh
  (i). Area of forest land proposed to be diverted(in ha.) : 1.71   (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).
1.1.71    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): 15   (iii). Temporary Employment(Number of person-days): 475000
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 ? : Yes   (a). Status of the Environmental Clearance to the Project: EC application yet to be submitted
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. : Pithoragarh
  (a). Village: BAKSIL   (b). Area(in ha.): 3.586   (c). Copy of KML file of the patch:     View File   (d). Khasra details: KHASRA NO. 33   (e). Present owner: User Agency   (f). Copy of Ownership proof:
  (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
1Certificate of District Majistrate for FRA 2006
2a short narrative and impotance of road
3Joint inspection report
4Comperative chart showing statement of both alignment or alternate site explored for the proposed project and reasons for their rejection
5Comperative chart showing statement of both alignment or alternate site explored for the proposed project and reasons for their rejection page 2
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. (pdf file)
7Land schedule
8Land schedule pg 2
9Category wise (RF,civil soyam, Van panchayat and private nap land, Notified forest land etc.) land length, width and area in Ha. (pdf file)
10Bar Chart
11Compensatory afforestation scheme in Civil and Soyam land (10 years) by DFO (pdf file) page 1
12Compensatory afforestation scheme in Civil and Soyam land (10 years) by DFO (pdf file) page 2
13Compensatory afforestation scheme in Civil and Soyam land (10 years) by DFO (pdf file) page 3
14Certificate Regarding. suitability of indentified land for Comensatory Afforestation by DFO (pdf file)
15Undertaking by the User Agency to bear the cost of compensatory afforestation duly counter signed by the DFO (pdf file)
16Road side/gap filling plantation estimate (by DFO) (pdf file)
17Undertaking by the User Agency to bear the cost of Road side /gap filling plantation (by user agency) (pdf file)
18Details 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 page 1
19Details 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 page 2
20Details 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 page 3
21Details 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 page 4
22Details 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 page 5
23Details 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 page 6
24Details 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 page 7
25Felling of Oak trees (if involves, inspection report of the concerning CF has to be provided). (pdf file)
26If felling of trees is not involved, certificate by DFO in this regard. (pdf file)
27Certificate of felling minimum trees during the project work. (pdf file)
28If the project area is within 10 Km radius of N/P or Centuary, Comments/No objection certificate of CCF Wild Life has to be provided. (pdf file)
29If 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. (pdf file)
30No voilation has taken place, FC Act. 1980 reg. (pdf file)
31Whather project area is a part of National Park or sanctuary and airal distance of the project from National Park or sanctuary signed by DFO. (pdf file)
32Khasra Khatoni detail
33N.O.C from villager's
34G.O. OF THE ROAD
35estimate of plantation
36Detail of tree
37Detail of tree
38Estimate of Muck Disposal
39Task Force
40Manak Sarte
41Geologist Report
42Distict Majistrate Certificate
43N.V.P Certificate
44N.V.P Certificate
45Other Documents
46F.R.A.