FORM - B
Form for seeking prior approval under Section-2 of the proposals by the State Governments and other authorities, in respect of renewal of leases,
which have been earlier granted clearance under Forest (Conservation) Act,1980
PART - I
(To be filled up by User Agency)
A. General Details
A-1. Project Details
  (i). Proposal No. : FP/AP/ROAD/28781/2017   (ii). Name of Project for which Forest Land is required : Chennai - Chittoor - Bangalore Road NH-4 road is included in NHDP-IV to upgrading to 4-lane from TN/AP Boarder to AP/KA Boarder Km 133/600 to 216/975 in Chittoor District, AP   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Chennai - Chittoor - Bangalore Road NH-4 road is included in NHDP-IV to upgrading to 4-lane from TN/AP Boarder to AP/KA Boarder Km 133/600 to 216/975 in Chittoor District, AP   (iv). State : Andhra Pradesh   (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) : 81200   (viii). Area of forest land proposed for diversion(in ha.): 23.23   (ix). Non-forest land required for this project(in ha.): 57   (x). Total period for which the forest land is proposed to be diverted(in years): NIL
A-2. Details of User Agency
  (i). Name : PROJECT DIRECTOR NHAI PIU TIRUPATI   (ii). Address1 : D.No.23/3/39/501, 5th Floor, Dhanalakshmi Nagar Vykuntapuram Road, MRPalli Tirupati   (iii). Address2 : Tirupati   (iv). State : Andhra Pradesh   (v). District : Chittoor   (vi). Pin : 517501   (vii). Landmarks : MR Palli   (viii). Email address : nhaitirupati@gmail.com   (ix). Landline Telephone No. : 00000000   (x). Fax No. : NIL   (xi). Mobile No. : 8897814276   (xii). Website (if any) : NIL   (xiii). Details of Proposals seeking prior approval of Central Government under the Act for diversion of forest land submitted by the User Agency in the past  
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
1InprincipleFP/AP/Others/28775/2017F.No.4-APB045-2017-CHN/160023.2323.2305 Oct 2017
Total 23.23 23.23
  (xiv). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: PD NHAI Tirupati   (ii). Middle Name: NIL   (iii). Last Name: Tirupati   (iv). Gender: Male   (v). Designation: Project Director   (vi). Address 1: National Highways Authority of India Project Implementation Unit - Dr. No.1-5-564/c. Balaji colony, Opp to Lakshmi Narayan Kalyana Mandapam, Tirupati-517502 Tirupati district Andhra Pradesh   (vii). Address 2: NIL   (viii). State: Andhra Pradesh   (ix). District: Tirupati   (x). Tehsil: NIL   (xi). Pin: 517502   (xii). Landmarks: NIL   (xiii). Email Address: nhaitirupati@gmail.com   (xiv). Landline Telephone No.: 2245060   (xv). Fax No.: NIL   (xvi). Mobile No.: 8897814276   (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:
A-7. Details of the forest land returned back to the State Forest Department or any other Authority from the forest land diverted in favour of the user agency
A-9. Details of Transfer of Lease
Serial No Name of person Address of person Date of transfer MMDR File Transfer Deed Conservation MoEF_file No Date of approval MoEF file
NIL
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
  (i). Whether any proposal seeking prior approval of Central Government under the Act for diversion of forest land required for the project has been submitted in the past?. : No
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.WL Chittoor East3.3320
2.Chittor West19.937
Total23.2357
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Chittoor23.2357
Total3.3320
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Gudipala, Chittoor3.3320
2Yadamarri, Bangarupalem, Palamaner, Gangavaram19.937
23.23 57
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road23.22998657
Total 23.229986 57
C. Maps of forest land proposed to be diverted
Division 1. : WL Chittoor East
  (i). Area of forest land proposed to be diverted(in ha.) : 3.33   (ii).Shape of forest land proposed to be diverted : Linear   (b). No. of Segments : Three
Segments wise details
Segmenst Segment Area(in ha.) Kml File of SegmentsTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0.52    View File
2.0.59    View File
3.2.22    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 DGPS or Total Station:
Division 2. : Chittor West
  (i). Area of forest land proposed to be diverted(in ha.) : 19.9   (ii).Shape of forest land proposed to be diverted : Linear   (b). No. of Segments : Three
Segments wise details
Segmenst Segment Area(in ha.) Kml File of SegmentsTo view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0.27    View File
2.11.48    View File
3.8.15    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 DGPS 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): 75   (iii). Temporary Employment(Number of person-days): 200000
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?: Yes   (a). Copy of Cost-Benefit analysis:
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? : No
L. Details of land identified for Compensatory Afforestation
  (i). Whether non-forest or Revenue forest land is required to be provided by User Agency?: NIL   (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 ?: NIL   (iii) . Reason for not providing Non-Forest Land: NIL
Additional information Details
Documents
S.No Documents
Remarks
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