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/HR/ROAD/21790/2016   (ii). Name of Project for which Forest Land is required : 4-Lanning from Km.3.335 to 3.675 & 4.575 to 6.875 on Bhiwani-Mundal-Jind-Karnal road New NH-709A   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Proposal for diversion of forest land for 4-Lanning from Km.3.335 to 3.675 & 4.575 to 6.875 (Bhiwani District) on Bhiwani-Mundal-Jind-Karnal road new NH-709A is required because existing width of the road is inadequate to cater the heavily increased volume of traffic. The town frequently suffer traf   (iv). State : Haryana   (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) : 1097.35   (viii). Area of forest land proposed for diversion(in ha.): 3.0096   (ix). Non-forest land required for this project(in ha.): 3.63   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : PUBLIC WORKS DEPARTMENT NH DIVISION   (ii). Address1 : Executive Engineer, National Highway Division, PWD B&R Br., Jind.   (iii). Address2 : Jind   (iv). State : Haryana   (v). District : Jind   (vi). Pin : 126102   (vii). Landmarks : Jind   (viii). Email address : pwdeenhjind@gmail.com   (ix). Landline Telephone No. : 249079   (x). Fax No. : NIL   (xi). Mobile No. : 7015171954   (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/HR/ROAD/21791/20169-HRB055/2017-CHA31.33216 Aug 2017
Total 31.33 2
  (xiv). Legal status of User Agency : Central Government
A-3. Details of Person Making Application
  (i). First Name: Mangat   (ii). Middle Name: NIL   (iii). Last Name: Ram   (iv). Gender: Male   (v). Designation: SDE   (vi). Address 1: National Highway Division PWD B&R Br., Jind   (vii). Address 2: Jind   (viii). State: Haryana   (ix). District: Jind   (x). Tehsil: Jind   (xi). Pin: 126102   (xii). Landmarks: Jind   (xiii). Email Address: pwdeenhjind@gmail.com   (xiv). Landline Telephone No.: 245079   (xv). Fax No.: NIL   (xvi). Mobile No.: 7015171954   (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.Bhiwani(West Circle Hissar)3.00963.63
Total3.00963.63
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bhiwani3.00963.63
Total3.00963.63
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1bhiwani city portion3.00963.63
3.0096 3.63
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Bhiwani-Mundal-Jind-Karnal3.00963.63
Total 3.0096 3.63
C. Maps of forest land proposed to be diverted
Division 1. : Bhiwani(West Circle Hissar)
  (i). Area of forest land proposed to be diverted(in ha.) : 3.0096   (ii).Shape of forest land proposed to be diverted : Linear   (b). No. of Segments : One
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.
1.3.0096    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: No   (a). Reason for not providing such map: NIL
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 30000   (iii). Temporary Employment(Number of person-days): 30000
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? : 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
1Copy of approval from the competent authority is attached for information & further necessary action please as the 4-lanning tender allotted to the agency shortly.
2FRA Certificate demanded by DFO Bhiwani as per letter No.436 dated 16.05.2017.
3Toposheet No.H43W1
4Forest Land Plan
5Linear Plan
6Brief Note
7Revised Brief Note
8Certificate from EE
9Scan Copy of KML File