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/33941/2018   (ii). Name of Project for which Forest Land is required : construction of Khutani-Bhawali-Dhanachuli-Okhalkanda-Khansyu-Patlot Motor Road. Valley Bridge in Km-85 of Khansyu, State Road No. 64 Proposed Span of New Bridge - 42.00 mtr.under section UDRP World Bank   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : After the construction of Bridge village such as Galani, Jhargaon Tall, Kala agar, Gargari Malli Chamoli, Dall Kanya and Gargari talli will be benefited such as- for going hospital, for marketing purpose etc.   (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) : 280   (viii). Area of forest land proposed for diversion(in ha.): 0.02   (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): 100
A-2. Details of User Agency
  (i). Name : PUBLIC WORKS DEPARTMENT   (ii). Address1 : Executive Engineer P.W.D. Bhowali   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Nainital   (vi). Pin : 263132   (vii). Landmarks : NIL   (viii). Email address : eepwdbhowali@rediffmail.com   (ix). Landline Telephone No. : 220029   (x). Fax No. : 220029   (xi). Mobile No. : 9412977376   (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: Anand   (ii). Middle Name: Ballabh   (iii). Last Name: Kandpal   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Executive Engineer, Ty. Div. P.W.D. Bhowali   (vii). Address 2: As above   (viii). State: Uttarakhand   (ix). District: Nainital   (x). Tehsil: Nainital   (xi). Pin: 263132   (xii). Landmarks: Nil   (xiii). Email Address: eepwdbhowali@rediffmail.com   (xiv). Landline Telephone No.: 220029   (xv). Fax No.: 05942220029   (xvi). Mobile No.: 9412977376   (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.Nainital0.020
Total0.020
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Nainital0.020
Total0.020
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Civel Land village Kala agar, No 10.0120
2Civel Land village Gargari Talli, No 20.0080
0.02 0
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Construction Bridge Abutment No 10.0120
2Construction Bridge Abutment No 20.0080
Total 0.02 0
C. Maps of forest land proposed to be diverted
Division 1. : Nainital
  (i). Area of forest land proposed to be diverted(in ha.) : 0.02   (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.
1.0.02    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): 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?: 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 doucument in support of the competence/authority of the person making this application to make application on behalf of the user agency.
2Copy of Survey of India Toposheet indicating boundary of forest Land proposed to be diverted.
3Seanned copy of the Geo-referenced map of the forest land proposed to be diverted prepared by using GPS/
4Note containing justification for locating the project in forest land (PDF file)
5Certificate by DM- Forest right act 2006 reg. ( in MOEF revised prescribed form ) (PDF file)
6A short narrative and importance of the project (pdf file)
7Administrative and Financial sanction (pdf file)
8Preliminary joint incpection report ( by user agency forest department , revenue department etc. (pdf file)
9Comperative chart showing statement of both alignment or alternate site explored for the proposed project and reasons for their rejection duly contersigned by DFO ( pdf file)
10Certificate from the DM that no alternative suitable non- forest land is available for the project in question and the demand of the forest land for the project is parest minimum. (PDF file)
11Land schedule ( for RF signed by DFO and civil soyam, Van pahchayat and private nap land signed by DM) ( pdf file)
12Category wise (R.F. civil soyan, Van panchayat and private nap land, notified forest land etc ) Land length, width and area in Ha. (pdf file)
13Bar Chart with index ( counter signed by DFO) (pdf file )
14If felling of trees is not involved, certificate by DFO in this regard. ( pdf file)
15Muck disposal scheme ( in prescribed formate ) (pdf file)
16Whather project area is a part of National Park or sanctuary and airal distance of the project from National Park or sanctuary signed by DFO ( pdf file )
17No vailation has taken place. FC act 1980 reg. (pdf file )
18NOC from local Gram Sabhas ( pdf file )
19objection removed vide letter no. 152/1c dt. 21.06.2018
20Certificate work has not been started reg. (pdf file)
21Geologidy report ( Govt. approved Geologist ) (pdf file)
22Task force report
23Standard Condition
24Certificate by user agency for complying the condition imposed in standard condition ( pdf file)
25Certificate by user agency for complying the condition imposed in geologist report / Task force recommendation in hill areas ( excluding drinding water )
26No historical /monumental or relegeous place will be effected certificate reg. ( by DM.DFO) (pdf file)
27Undertaking regarding no animal will be effected adversely by the project ( pdf file )
28Undertaking to provide alternative fuelwood kerosene or LPG to labour involeved in project ( pdf file )
29Benefited villages/ Families / Population certificate ( pdf file )
30NPV calculation certificate as per Hon'ble Supreme Court / MoEF order by DFO ( pdf file )
31Undertaking of payment of NPV, if Hon'ble Superem Court increses the rates of NPV ( by user agency ) (pdf file )
32Check list / Fact sheet