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/KA/ROAD/154088/2022
(ii). Name of Project for which Forest Land is required :
Diversion of 0.02460 ha of forest land for connectivity road [for residential Layout purpose] falls in Sy No.81 of Bachaganv Village, Bachaganv Deemed Forest, Sirsi Hobli, & Taluk, U.K District, Sirsi
(iii). Short narrative of the proposal and Project/scheme for which the forest land is required :
Diversion of 0.02460 ha of forest land for connectivity road fall in Sy No.81 of Bachaganv Village & Deemed Forest & 2.5837 ha of non-forest land for residential Layout & Road at F.Sy No.50/1 & 49 of Bachaganv (V), Sirsi (T), U.K (D) in favour of Venkataraman Govind Bhat, Tuduguni Village, Sirsi
(iv). State :
Karnataka
(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) :
40
(viii). Area of forest land proposed for diversion(in ha.):
0.0246
(ix). Non-forest land required for this project(in ha.):
2.5837
(x). Total period for which the forest land is proposed to be diverted(in years):
50
A-2.
Details of User Agency
(i). Name :
VENKATARAMAN GOVIND BHAT, TUDUGUNI VILLAGE, SIRSI TALUK, KUMTA ROAD, UTTARA KANNADA DISTRICT
(ii). Address1 :
VENKATARAMAN GOVIND BHAT, TUDUGUNI VILLAGE, SIRSI TALUK, KUMTA ROAD U.K. DISTRICT.
(iii). Address2 :
NIL
(iv). State :
Karnataka
(v). District :
Uttara Kannada
(vi). Pin :
581401
(vii). Landmarks :
KUMTA ROAD SIRSI
(viii). Email address :
nykgopal7@gmail.com
(ix). Landline Telephone No. :
NIL
(x). Fax No. :
NIL
(xi). Mobile No. :
7259813531
(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
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
(xiv). Legal status of User Agency :
Private
A-3.
Details of Person Making Application
(i). First Name:
Venkataraman
(ii). Middle Name:
Govind
(iii). Last Name:
Bhat
(iv). Gender:
Male
(v). Designation:
Farmer
(vi). Address 1:
Venkataraman Govind Bhat, Tuduguni Village, Kumta Road, Sirsi Taluk, U.K District.
(vii). Address 2:
NIL
(viii). State:
Karnataka
(ix). District:
Uttara Kannada
(x). Tehsil:
Sirsi
(xi). Pin:
581401
(xii). Landmarks:
Kumta Road Sirsi
(xiii). Email Address:
nykgopal7@gmail.com
(xiv). Landline Telephone No.:
NIL
(xv). Fax No.:
NIL
(xvi). Mobile No.:
7259813531
(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.
Sirsi
0.0246
2.5837
Total
0.0246
2.5837
B-2.2
Details of Districts involved
District wise breakup
S.no
District Name
Forest Land(ha.)
Non-Forest Land(ha.)
1.
Uttara Kannada
0.0246
2.5837
Total
0.0246
2.5837
B-2.3
Village wise breakup
Villages wise breakup
S.no
Village
Forest Land(ha.)
Non-Forest Land(ha.)
1
Sy No.81 of Bachaganv Village
0.0246
0
2
Sy No.49 of Bachaganv Village
0
0.2568
3
Sy No.50/1 of Bachaganv Village
0
2.3269
0.0246
2.5837
B-2.4
Component wise breakup
Component wise breakup
S.no
Component
Forest Land(ha.)
Non-Forest Land(ha.)
1
Connectivity Road
0.0246
0.2568
2
Residential Layout Land
0
2.32689
Total
0.0246
2.58369
C.
Maps of forest land proposed to be diverted
Division 1. : Sirsi
(i). Area of forest land proposed to be diverted(in ha.) :
0.0246
(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 Segments
To view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.
0.0246
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):
5
(iii). Temporary Employment(Number of person-days):
50
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?:
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
1
Alternative Examine in details marked on maps
2
Google Map-1
3
Google Map-2
4
Layout Deed Copy
5
Patta land converted for Non Agriculture purpose .Copy Enclosed
6
NPV Undertaking
7
Plain Map
8
Demarcation of Stone Pillar Undertaking
9
CA Undertaking
10
ROFR Undertaking
11
Sy No.50-1 of Bachaganv Village - Layout -RTC Copy
12
Sy No.81 of Bachaganv Village - Proposed Road Forest Land -RTC Copy
13
SALE DEED Copy
14
Town Plan and Town Ship Map