View Form B Part 1

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/RJ/WATER/18810/2016 (ii). Name of Project for which Forest Land is required : BORABAS MANDANA WATER SUPPLY PROJECT KOTA (RAJASTHAN) (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Borabas Mandana Water Supply Project was framed to cater drinking water demand of 60 villages & 21 OH of district Kota,approximate 361 KM pipeline is laying in these villages for water supply. (iv). State : Rajasthan (v). Category of the Proposal : Drinking Water (vi). Shape of forest land proposed to be diverted : Linear (vii). Estimated cost of the Project(Rupees in lacs) : 9047.48 (viii). Area of forest land proposed for diversion(in ha.): 4 (ix). Non-forest land required for this project(in ha.): 19.14 (x). Total period for which the forest land is proposed to be diverted(in years): 99

A-2.	Details of User Agency

(i). Name : EXECUTIVE ENGINEER PHED PROJECT DIVISION I KOTA (ii). Address1 : PHED PROJECT DIVISION-I, DADABARI KOTA (iii). Address2 : NIL (iv). State : Rajasthan (v). District : Kota (vi). Pin : 324009 (vii). Landmarks : NEAR CHAMBAL GARDEN (viii). Email address : hemant_phed@rediffmail.com (ix). Landline Telephone No. : 2501961 (x). Fax No. : 2501961 (xi). Mobile No. : 8387891666 (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 : State Government

A-3.	Details of Person Making Application

(i). First Name: PRAKASH (ii). Middle Name: CHAND (iii). Last Name: JAIN (iv). Gender: Male (v). Designation: EXECUTIVE ENGINEER (vi). Address 1: PHED PROJECT DIVISION-I,DADABARI KOTA (vii). Address 2: NIL (viii). State: Rajasthan (ix). District: Kota (x). Tehsil: Ladpura (xi). Pin: 324009 (xii). Landmarks: NEAR CHAMBAL GARDEN (xiii). Email Address: hemant_phed@rediffmail.com (xiv). Landline Telephone No.: 2501961 (xv). Fax No.: 07442501961 (xvi). Mobile No.: 8387891666 (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.	Mukundra NP	0.86	0.76
2.	Kota Territorial	3.14	18.38
Total		4	19.14

B-2.2

Details of Districts involved

District wise breakup
S.no	District Name	Forest Land(ha.)	Non-Forest Land(ha.)
1.	Kota	4	19.14
Total		0.86	0.76

B-2.3

Village wise breakup

Villages wise breakup
S.no	Village	Forest Land(ha.)	Non-Forest Land(ha.)
1	Borabas	0.12454	0.3309
2	Prathvipura	0.0455	0.09048
3	Keshopura	0.1045	0.07774
4	jaspura	0.1924	0
5	Rojhala	0.1237	0
6	Mandirgarh	0.03978	0.0429
7	Rathkankara	0.10426	0.1422
8	Kishanpura	0.13052	0.08086
9	Lakshmipura@kolana	0.3997	0
10	Khanpuriya	0.1045	0
11	Ranpur	0.048	0.38
12	Daulatganj	0.1819	0.32
13	Rojhari	0.1817	0.16
14	Vijaypura	0.168	0
15	Jagpura	0.3399	0.54
16	Pachankui	0.2558	0
17	Bandha	0.0566	0.34
18	Kishor sagar	0.0072	0
19	Anandpura@Foot Talav	0.0788	0.24
20	Anandpura	0.1496	0.36
21	Lakhawa	0.2601	0.42
22	Kable Nagar	0.1275	0.16
23	Sohanpura	0	0.7
24	Gopalpura	0	0.96
25	Kaliyakheri	0	0.54
26	Ummedpura	0	0.41
27	Daulatpura	0	0.23
28	Anwali	0	0.12
29	Aalniya	0.012	0.28
30	Mandliya	0	0.4
31	Dobra	0.0338	0.57
32	Jodhpura	0	0.3
33	Sarangpur	0.0804	0.2
34	Tholpura	0	0.45
35	Kasar	0.0807	0.47
36	Bakshpura	0	0.45
37	Shayampura	0.111	0.38
38	Baudikhera	0	0.24
39	Rankayakheri	0.153	0.49
40	Heerapura	0	0.39
41	Pachpahar	0.0758	0.26
42	Nayagaon (Dobra)	0	0.52
43	Doliya	0.2274	0.31
44	Kanwarpura	0	0.23
45	Mandana	0	1.23
46	Bhilod	0	0.29
47	Bhilkheri	0	0.36
48	Phatakhera	0	0.42
49	Bhanwariya	0	0.46
50	Kothala	0	0.26
51	Dharampura	0	0.41
52	Mukundpura	0	0.46
53	Mohanpura	0	0.37
54	Chandbaori	0	0.26
55	Ranwtha	0	0.52
56	Singhpura	0	0.25
57	Hanotiya	0	0.48
58	Morukalan	0	0.2
59	Haripura	0	0.26
60	Morukhurad	0	0.29
		3.9986	19.10508

B-2.4

Component wise breakup

Component wise breakup
S.no	Component	Forest Land(ha.)	Non-Forest Land(ha.)
1	Laying of Pipeline@350 mm	0.71383	0.47617
2	Laying of Pipeline@250	0.5928	1.031025
3	Laying of Pipeline@200 mm	0.3213	1.8522
4	Laying of Pipeline@150 mm	0.85475	3.540615
5	Construction of ESR	0	2.76
6	Laying of Pipeline@100 mm	1.458478	9.41946
Total		3.941158	19.07947

C.	Maps of forest land proposed to be diverted

Division 1. : Mukundra NP

(i). Area of forest land proposed to be diverted(in ha.) : 0.86 (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.	0.86	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. : Kota Territorial

(i). Area of forest land proposed to be diverted(in ha.) : 3.14 (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.	0.713	View File
2.	0.592	View File
3.	0.321	View File
4.	0.854	View File
5.	0.659	View File
6.	1E-10	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): 0 (iii). Temporary Employment(Number of person-days): 150

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? : Yes (a). Whether Project or a part thereof is located within a Protected Area ? : Yes (b). Status of approval of the Supreme Court : Approval obtained (c). Date of Approval : NIL (d).Copy of the approval of the Supreme Court:

(ii). Status of approval of the Standing Committee of National Board for the Wildlife(NBWL) to the Project : Approval obtained (a). MoEF File No : F.No.6-48/2015 WL (34th Meeting) (b). Copy of approval of Standing of the NBWL:

(c). Date of Approval : 24 Jun 2015

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. : Kota

(a). Village: Jodhpura (b). Area(in ha.): 4 (c). Copy of KML file of the patch:

View File (d). Khasra details: 407 (e). Present owner: Others (f). Copy of ownership proof:

(g). Copy of Mou/agreement executed between the Present owner and the User Agency:

(h). Copy of non encumberence certificate for the forest land:

(v). Scanned copy of the map of the land identified for creation of Compensatory Afforestation prepared by using DGPS 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
1		CA Land Documents.
2		Railway NOC.
3		Khasra Map.
4		Augmentation Plan.
5		Forest Land Village List.
6		Wildlife Village List.
7		Bar Chart Status.
8		Borabas Mandana Area Calculation Sheet.
9		FRA Certificate Additional Details.
10		GOOGLE MAP.
11		Work Order and Agreement Letter.
12		Technical Sanction.
13		Administration and Financial Sanction.
14		NBWL Permission.
15		Wildlife Clearance Letter.
16		NHAI NOC.
17		JUSTIFICATION FOR LOCATING PROJECT IN FOREST AREA.
18		Undertaking for Use of Any Material From Forest Land.
19		UNDERTAKING FOR CONSERVATION OF FLORA FAUNA DURING LAYING OF PIPELINE.
20		UNDERTAKING FOR NO CHANGES IN STATUTORY POSITION OF DIVERTED FOREST LAND.
21		UNDERTAKING FOR NO OTHER FEASIBLE ALTERNATIVE AND DIVERSION OF MINIMUM FOREST LAND.
22		UNDERTAKING FOR PAYMENT OF ANY OTHER COST AND CONDITION.
23		UNDERTAKING FOR PAYMENT OF COST OF COMPENSATORY AFFORESTATION.
24		UNDERTAKING FOR PAYMENT OF NET PRESENT VALUE OF FOREST AREA.
25		UNDERTAKING FOR USE OF FOREST LAND.
26		Undertaking for Waste Management.