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/ROAD/12710/2015   (ii). Name of Project for which Forest Land is required : Construction of Bageshwar-Balighat-Dharmghar motor road to Khantola(Khitoli) Bridge to Gurgucha Basic School motor road(Length 3.00 km)   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Construction to Khantola(Khitoli) Bridge to Gurgucha Basic School motor road(Length 3.00 km) Starting from Km 20 of BDDK Motor Road. Connecting Villages of Gurgucha,Basic School in Teshsil-Kapkot, District-Bageshwar   (iv). State : Uttarakhand   (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) : 138   (viii). Area of forest land proposed for diversion(in ha.): 0.63   (ix). Non-forest land required for this project(in ha.): 1.485   (x). Total period for which the forest land is proposed to be diverted(in years): 100
A-2. Details of User Agency
  (i). Name : PWDKAPKOT   (ii). Address1 : C.D.P.W.D.KAPKOTE   (iii). Address2 : BAGESHWAR   (iv). State : Uttarakhand   (v). District : Bageshwar   (vi). Pin : 263642   (vii). Landmarks : Kapkot   (viii). Email address : cdpwdkapkot@gmail.com   (ix). Landline Telephone No. : 253385   (x). Fax No. : 253385   (xi). Mobile No. : 9719471059   (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 : Central Government
A-3. Details of Person Making Application
  (i). First Name: Sanjay Kumar Pandey   (ii). Middle Name: Kumar   (iii). Last Name: Pandey   (iv). Gender: Male   (v). Designation: E.E.   (vi). Address 1: C.D.P.W.D.KAPKOTE   (vii). Address 2: BAGESHWAR   (viii). State: Uttarakhand   (ix). District: Bageshwar   (x). Tehsil: Kapkot   (xi). Pin: 263642   (xii). Landmarks: kapkot   (xiii). Email Address: cdpwdkapkot@gmail.com   (xiv). Landline Telephone No.: 253385   (xv). Fax No.: 05963253385   (xvi). Mobile No.: 9719471059   (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.Bageshwar0.631.485
Total0.631.485
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bageshwar0.631.485
Total0.631.485
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Gurgucha0.631.485
0.63 1.485
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road0.630.765
2Muck Dispogal00.72
Total 0.63 1.485
C. Maps of forest land proposed to be diverted
Division 1. : Bageshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 0.63   (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.
1.0.63    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): 10800
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
1EDS Dated 01-09-2017
2Hard copy letter
3Nodal office send to Hard Copy Government of India
4Sir the hard copy of the proposal has been submitted with the referenced letter no-81/2E dated 10-01-2017.
5FRA DOCUMENT
6containing justification for locating the Project in forest land
7Certificate by DM- Forest right act 2006 reg.(in MoEF revised (FRA)
8A 1.9If non-forest or Revenue forest land is required to be provided by
9Copy of Mou/agreement executed between the Present owner and
10Administrative and Financial sanction
11Preliminary Joint Inspection report
12Comperative chart showing statement of both alignment or alternate
13Certificate from the DM that no alternative suitable non-forest
14Land schedule (for RF signed by DFO and civil soyam, Van
15Land schedule (Khshra)
16Category wise (RF,civil soyam, Van panchayat and private nap land
17Bar Chart with index (counter signed by DFO).
18Compensatory afforestation scheme in Civil and Soyam land (10 year
19reg. suitability of indentified land for Comensatory
20Undertaking by the User Agency to bear the cost of compensatory
21Road side/gap filling plantation estimate
22Details of the trees with their scientific name in RF, Civil Soyam 0-10 dia trees will be mentioned as saplings
23Felling of Oak trees (if involves, inspection report of the concerning
24Certificate of felling minimum trees during the project work.
25Muck disposal scheme (
26Whether project area is a part of National Park or sanctuary and airal
27No voilation has taken place, FC Act. 1980 reg.
28NOC from local Gram Sabhas.
29Certificate- work has not been started reg
30Geologist Report (Govt. approved Geologist).
31Task Force report
32Manak Shartain
33Certificate by user agency for complying the condition imposed ingeologist report/Task Forcex
34No historical/monumental or relegeous place will be effected
35Undertaking regarding no animal will be effected adversely by the
36Undertaking to provide alternative fuelwood, kerosene or LPG to
37Benefited villages /Families/ Population certificateBenefited villages /Families/ Population certificate
382.36NPV calculation certificate as per Hon'ble Supreem court /MoEF
39Undertaking of payment of NPV, if Hon'ble Supreem Court increses
40other doc
41Check list/Fact sheet.
42Obj remove Proposal No- 12710/2015 Obj dated 27-04-2016
43EDS Dated 24-04-2016 & 26-10-2015
44Receiving copy
45Eds Dated 25-09-2019
46Eds Dated 30-04-2021
47Eds Dated 28-11-2019
48Eds dated 04-09-2021
49eds Dated 19-08-2020
50Eds dated 19-09-2020
51Eds Dated 11-11-2020
52Eds Dated 21.01.2021
53khantoli bridge eds dated 25-05-2022
54Eds Dated 16-08-2021
55Eds Dated 29-12-2021
56eds Dated 28-09-2024
57Balighat
58Eds Dated 06-08-2024
59Eds Dated 30-07-2025_2025
60Eds Dated 30-07-2025