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/UP/ROAD/141411/2021   (ii). Name of Project for which Forest Land is required : Widening & Up-gradation of NH-135A from Km. 34.900 (Bhadohi) to Km 73.134 at Jaunpur in the state of Uttar Pradesh.   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Widening & Up-gradation to four lane configuration from Km. 34.900 (Bhadohi) to Km 54.150 and from Km. 58.800 to Km. 70.400 (Jaunpur Bypass section) and to two lane with paved shoulder from km 54.150 to km 58.800 & from Km 70.400 to Km 73.134of NH-135A in the state of Uttar Pradesh on EPC mode.   (iv). State : Uttar Pradesh   (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) : 39562   (viii). Area of forest land proposed for diversion(in ha.): 65.612   (ix). Non-forest land required for this project(in ha.): 34.085   (x). Total period for which the forest land is proposed to be diverted(in years): 99
A-2. Details of User Agency
  (i). Name : NH DIVISION NO 1, PWD VARANASI   (ii). Address1 : Office of Executive Engineer, NH Division No-1, PWD Varanasi   (iii). Address2 : Near Varuna Bridge, Nadesar, Varanasi.   (iv). State : Uttar Pradesh   (v). District : Varanasi   (vi). Pin : 221002   (vii). Landmarks : NIL   (viii). Email address : pwdvaranasi@yahoo.com   (ix). Landline Telephone No. : NIL   (x). Fax No. : NIL   (xi). Mobile No. : 9415164914   (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: Mritunjay   (ii). Middle Name: Singh   (iii). Last Name: Yadav   (iv). Gender: Male   (v). Designation: Executive Engineer   (vi). Address 1: Office of Executive Engineer, NH division No-1, PWD Varanasi   (vii). Address 2: Near Varuna Bridge, Nadesar, Varanasi.   (viii). State: Uttar Pradesh   (ix). District: Varanasi   (x). Tehsil: Varanasi   (xi). Pin: 221002   (xii). Landmarks: NIL   (xiii). Email Address: pwdvaranasi@yahoo.com   (xiv). Landline Telephone No.: 0   (xv). Fax No.: NIL   (xvi). Mobile No.: 9415164914   (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.Social Forestry Division Jaunpur65.61234.085
Total65.61234.085
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Jaunpur65.61234.085
Total65.61234.085
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Pachwal4.7266.385
2Sidhvan3.3661.411
3Mai2.210.967
4Dhanuha1.4280.608
5Rampur Dhanuha1.9551.001
6Khemapur1.360.573
7Kotgaon0.9350.385
8Gandhauna2.3121.036
9Aura2.4481.03
10Kumbhapur0.1280.052
11Raipur Sarai bikram1.0630.438
12Jogapur1.6660.686
13Jamalpur1.9040.835
14Sarauna1.530.645
15uttampur0.8330.361
16Seer0.2550.227
17seur3.0941.355
18Katghara0.5270.258
19Shivpur2.5730.917
20Ranipur2.4380.742
21Dilawarpur4.831.564
22Khijirpur0.6670.207
23Sarai Khurd0.4830.147
24Jogapuur1.710.63
25Maidieh0.4760.314
26Soitha1.2240.522
27Basdev Patti0.3660.4
28Majhawat0.4850.2
29Ahirauli1.5810.651
30Pali1.1650.48
31Subhaspur1.1650.48
32Chaktala1.190.562
33Rampur0.680.28
34Sikandarpur1.4960.752
35Unchanikalan1.5981.319
36Unchanikhurd0.6970.582
37Gahora1.361.208
38Kuddupur1.2070.747
39Ranjitpur1.9720.825
40Kadipur0.2040.084
41Harbuspur0.0510.06
42Madarpur Doyam0.3830.158
43Phoolpur Arazi1.5650.665
44Saidanpur0.1630.088
45Raibhanipur0.4550.245
46Chandpur1.1440.616
47Umarpur0.1480.079
48Jaunpur0.3960.308
65.612 34.085
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Construction of road64.14629.1475
2Toll Plaza, facilities, office building and its ap1.39964.8877
3Construction of Bridge0.06640.0498
Total 65.612 34.085
C. Maps of forest land proposed to be diverted
Division 1. : Social Forestry Division Jaunpur
  (i). Area of forest land proposed to be diverted(in ha.) : 65.612   (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.
1.65.612    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: No   (a). Reason for not providing such map: The road is widening of existing road. hence no ot
E. Employment likely to be generated
  (i). Whether the Project is likely to generate employment ?: Yes   (ii). Permanent/Regular Employment(Number of persons): 20   (iii). Temporary Employment(Number of person-days): 120000
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?: Yes   (a). Copy of Cost-Benefit analysis:
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? : No
L. Details of land identified for Compensatory Afforestation
  (i). Whether non-forest or Revenue forest land is required to be provided by User Agency?: No   (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: Linear or 'strip' plantation declared as protected forest along with road/rail/canal sides for widening or expansion of road/rail/canal
Additional information Details
Documents
S.No Documents
Remarks
1Project Sanction Letter
2NOC of other agencies
3road side plantation scheme
4Cross Section Design
5Forest Notification
6Muck Disposal Plan
7NOC not required as land belongs to PWD itself.
8Coordinates of Ex. Road Center line Bhaodohi to Jaunpur road
9Linear Plan of Bhadohi to Jaunpur
10Cost of the project
11Area Statement
12Part I
13Benificiary details
14Detail Note
15Manak Sharte
16No other Alternative
17Protected area
18Undertaking for Archaelogical Site
19Undertaking for EC
20Undertaking for Flora and Fauna
21Undertaking for FRA
22Undertaking for No work without permission
23Undertaking for NPV and Addl NPV
24Undertaking for Task Force
25Undertakings for CA
26Van Swarup