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/WATER/14692/2015   (ii). Name of Project for which Forest Land is required : Diswane Malli Water Supply Scheme   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Diswane Malli Water Supply Scheme   (iv). State : Uttarakhand   (v). Category of the Proposal : Drinking Water   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 10.55   (viii). Area of forest land proposed for diversion(in ha.): 0.186   (ix). Non-forest land required for this project(in ha.): 0.048   (x). Total period for which the forest land is proposed to be diverted(in years): 15
A-2. Details of User Agency
  (i). Name : UTTARAKHAND PAYJAL SANSADHAN VIKAS AVAM NIRMAN NIGAM   (ii). Address1 : Executive Engineer, Construction Division, Pauri   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Pauri Garhwal   (vi). Pin : 246001   (vii). Landmark : Near laxmi Narayan Mandir   (viii). Email address : pjnpauridn@gmail.com   (ix). Landline Telephone No. : 1368-222246   (x). Fax No. : 1368-222387   (xi). Mobile No. : 9412030037   (xii). Website (if any) : NIL   (xiii). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Prakesh   (ii). Middle Name: Chandra   (iii). Last Name: Gouttam   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Executive Engineer, Construction Division, Pauri   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Pauri Garhwal   (x). Tehsil: Pauri   (xi). Pin: 246001   (xii). Landmark: Near laxmi Narayan Mandir   (xiii). Email Address: pjnpauridn@gmail.com   (xiv). Landline Telephone No.: 1368-222246   (xv). Fax No.: 01368222387   (xvi). Mobile No.: 8191047235   (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.Garhwal,Pauri0.1860.048
Total0.1860.048
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Pauri Garhwal0.1860.048
Total0.1860.048
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Bharpoor0.08580
2Diswanee0.10020.048
Total 0.186 0.048
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Pipeline0.1860.048
Total 0.186 0.048
C. Maps of forest land proposed to be diverted
Division 1. : Garhwal,Pauri
  (i). Area of forest land proposed to be diverted(in ha.) : 0.186   (ii). Nature of the Project: Non Linear   (a). No. of patches : One
Patch wise details
Patch No. Area of Patch(in ha.) Kml File of PatchesTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0.037    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:
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): 2100
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
1Front Page containing Name & Cost
2Fact Sheet
3Fact Sheet (Page 2)
4Fact Sheet (Page 3)
5Praaroop 2
6Financial Approval Letter from General Manager (Swap)
7Financial Approval Letter from General Manager (Swap) containing name of this scheme
8Joint Inspection Report
9Digital Map of Scheme with GPS reading showing Latitude & Longitude
10Digital Map of Scheme on Google Map
11Proof of Financial & Technical Approval
12Proof of Non-availability of alternative land and that the forest land demand is minimum
13Proof of Reserved Forest Land
14Proof of Civil, Soyam & Naap Bhoomi
15Proof of Length, width & Area of Scheme
16Bar Chart Showing Source & Pipe Line Works
17Proof That the work has not been started
18Proof That no tree will be affected by the scheme
19Proof that the desired forest land is not a part of any National Park or Sanctuary and document showing the distance of required land from nearest National Park/Sanctuary
20NOC from Gram Pradhan
21Task Force Certificate
22Standard Terms & Conditions Certificate Certificate
23Certificate Proof that the desired land is non-religious, non-historic
24Certificate of Non Damage to vegetation and animals
25Certificate Showing Benefited Population
26Certificate Showing Lease rent
27Plan for cultivation of 100 Treees
28Certificate for Increased NPV rates submission
29Certificate showing lease period
30Certificate showing Non-violation of 1980 Act