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/UK/DISP/114282/2020   (ii). Name of Project for which Forest Land is required : Construction of State Cancer Institute by upgrading of existing Swami Ram Cancer Hospital at Haldwani   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Swami Ram Cancer Hospital Haldwani is catering Cancer treatment to the population of Uttarakhand and nearby States since 12 years. Government of India is sponsoring funds to upgrade it as State Cancer Institute. Beside it a 200 bedded Infection Disease Hospital (i.e. Covid-19 Pandemic) is proposed.   (iv). State : Uttarakhand   (v). Category of the Proposal : Dispensary/Hospital   (vi). Shape of forest land proposed to be diverted : Non Linear   (vii). Estimated cost of the Project(Rupees in lacs) : 8888.75   (viii). Area of forest land proposed for diversion(in ha.): 4.25   (ix). Non-forest land required for this project(in ha.): 0   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : GOVERNMENT MEDICAL COLLEGE HALDWANI   (ii). Address1 : Rampur Road, Haldwani   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Nainital   (vi). Pin : 263139   (vii). Landmarks : NIL   (viii). Email address : principal.gmchld@rediffmail.com   (ix). Landline Telephone No. : 282824   (x). Fax No. : NIL   (xi). Mobile No. : 9412410759   (xii). Website (if any) : www.gmchld.org   (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
1Under Processing at State GovernmentFP/UK/DISP/6879/201415.8920
Total 15.892 0
  (xiv). Legal status of User Agency : State Government
A-3. Details of Person Making Application
  (i). First Name: Dr R   (ii). Middle Name: C   (iii). Last Name: Purohit   (iv). Gender: Male   (v). Designation: Principal   (vi). Address 1: Government Medical College,Rampur Road, Haldwani   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Nainital   (x). Tehsil: NIL   (xi). Pin: 263139   (xii). Landmarks: NIL   (xiii). Email Address: principal.gmchld@rediffmail.com   (xiv). Landline Telephone No.: 282824   (xv). Fax No.: 05946282578   (xvi). Mobile No.: 9412410759   (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.Tarai Central,Haldwani4.250
Total4.250
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Nainital4.250
Total4.250
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Haldwani Khas4.250
4.25 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Patch-2 New R.T. Block0.1250
2Patch1- Nuclear Medicine Lab, Radiodiagnosis and L2.5150
Total 2.64 0
C. Maps of forest land proposed to be diverted
Division 1. : Tarai Central,Haldwani
  (i). Area of forest land proposed to be diverted(in ha.) : 4.25   (ii).Shape of forest land proposed to be diverted : Non Linear   (a). No. of patches : Two
Patch wise details
Patch No. Area of Patch(in ha.) Kml File of Patches To view KML file on google the same may be downloaded and then open if in google earth install in your computer.
1.0.44    View File
2.2.671    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:
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 156   (iii). Temporary Employment(Number of person-days): 1000
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?: 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. : Pithoragarh
  (a). Village: Ramtoli   (b). Area(in ha.): 5.28   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 2288   (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: No Data   (vi). Copy of Survey of India Toposheet in 1:50,000 scale indicating location of the land identified for creation of Compensatory Afforestation: No Data
Additional information Details
Documents
S.No Documents
Remarks
1Reply of quay dated 15.12.2021. Revised layout required only 3.111 ha. forest land while exclusion of future construction as per instruction given by R.O. Forest Land, Dehradun.
2orm 6- Toposheet Map of 3.111 H Forest Land
3Form 7- Geo Reference Map of 3.111 H Forest Land
4Google Map (Revised) 3.111 H Forest Land
5Reply of GoI query dated 26-02-2021 of letter no. 8B/UCP/09/21/2021/FC/2373
6Reply of Query raised by Nodal Office vide letter no-1099/FC/UK/DISP/114282/2020 dated 21-10-2022
7Cover Page
8Check List/Fact Sheet
9Index
10Form 1- Short narrative of the Project
11Form 3-Administrative and Financial Approval
12Form 4- Joint Inspection Report
13Form 5- Site Inspection Report of DFO
14Form 8- Cancelation of alternative alignment
15Form-9 - Comparative description of various option in land
16Form-10 - No other alternate is and requirement of minimum land
17Form-11 Land schedule (Forest Deptt)
18Form-11 A Land schedule (Revenue Deptt)
19Form-12 - Length and width of the land
20Form-13 - Bar chart of the land
21Form-14 - Certification for new construction not started
22Form-16- Site inspection report of Baanj Tree on proposed land
23Form-17- Minimum tree fallen certificate
24Form-18- Certification for not a part of National park or wildlife centaury
25Form-19- Certification for distance from National park or wildlife centaury
26Reply of Nodal Queries dated 12-04-2021
27CA Scheme Authenticated by DFO
28Reply of query raised by Nodal Office vide letter no 79/FP/UK/DISP/114282/2020 dated 07.07.2022 and MoEF letter no 8B/UCP/09/21/2021/FC/1192 dated 15.12.2021
29Form-20- Certificate (Not required due to proposed land distance is more than 10 k.m. from National park/wildlife centaury)
30Form-21- NOC from general meeting of ward-53
31Form-23- NOC from SMD level committee, DM level committee
32Form-23- NOC from Ward and Nagar Nigam committee
33FRA Certificate
34Form-26- Geological report
35Form-27- Task Force Certificate
36Letter regarding Muck Disposal Scheme Not Required.
37Form- 28 - Task force recommendation
38Form- 29 - Manak terms acceptable
39Form- 30 - No holy place
40Form- 31 - No harm to animals
41Form- 33 - Benefit to population
42Form- 34 - Lease rent certificate
43Form- 35 - CA estimate
44Form- 36 - Appropriate land for CA
45Form- 37 - Plantation estimate in blank spaces
46Form- 38 - Plantation amount deposit certificate
47Form- 39 - CA amount deposit certificate
48Form- 42 - NPV amount calculation
49Form- 43 - NPV amount deposit certificate
50Form- 44 - RCC pillar estimate
51Form- 46 - Non violation certificate
52Civil Land provided by DM Pithoragarh for CA provided by DM Pithoragarh
53Reply of query raised by GoI dated 31-08-2021
54As per direction of RO, revised plan is being uploaded herewith.
55As per direction of RO, revised Layout plan of 2.64 hectare required Forest Land is being uploaded herewith.
56Revised CA Estimate
57Revised Estimate of RCC Piller
58Revised list of affected tree
59Revised google map of CA land
60Revised google map of required forest land
61Tree counited in proposed land and its estimate.
62Reply of GoI query dated 09-05-2023 of letter no. 8B/UCP/09/21/2021/FC/146.
63Revised layout Plan and buildings maps.