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/16306/2015   (ii). Name of Project for which Forest Land is required : Rawatsera-Dobargara-Dhari-Madhya-Raitoli motor road in District-Bageshwar   (iii). Short narrative of the proposal and Project/scheme for which the forest land is required : Proposal for diversion of 2.425 ha. forest land for construction of motor road. detail narrative attached form-11 (2.1) in additional enclosure.   (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) : 0.1   (viii). Area of forest land proposed for diversion(in ha.): 2.425   (ix). Non-forest land required for this project(in ha.): 1.155   (x). Total period for which the forest land is proposed to be diverted(in years): 50
A-2. Details of User Agency
  (i). Name : PROVINCIAL DIVISION PWD BAGESHWAR   (ii). Address1 : Provincial Division PWD Bageshwar   (iii). Address2 : NIL   (iv). State : Uttarakhand   (v). District : Bageshwar   (vi). Pin : 263642   (vii). Landmarks : Kathayatbara   (viii). Email address : pdpwdbgr@gmail.com   (ix). Landline Telephone No. : 220006   (x). Fax No. : NIL   (xi). Mobile No. : 9719974196   (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: Nawal   (ii). Middle Name: Kishor   (iii). Last Name: Diwedi   (iv). Gender: Male   (v). Designation: Assistant Engineer   (vi). Address 1: Provincial Division PWD Bageshwar   (vii). Address 2: NIL   (viii). State: Uttarakhand   (ix). District: Bageshwar   (x). Tehsil: Bageshwar   (xi). Pin: 263642   (xii). Landmarks: Kathayatbara   (xiii). Email Address: pdpwdbgr@gmail.com   (xiv). Landline Telephone No.: 220006   (xv). Fax No.: 05963220006   (xvi). Mobile No.: 9719974196   (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.Bageshwar2.4251.155
Total2.4251.155
B-2.2 Details of Districts involved
District wise breakup
S.no District Name Forest Land(ha.) Non-Forest Land(ha.)
1.Bageshwar2.4251.155
Total2.4251.155
B-2.3 Village wise breakup
Villages wise breakup
S.no Village Forest Land(ha.) Non-Forest Land(ha.)
1Basukinag R.F.0.6460
2Dobargarah0.3520
3Talla Dhari & Tok Dhatiyadhunga0.4220.504
4Malla Dhari1.0050.35
5Raitoli00.301
2.425 1.155
B-2.4 Component wise breakup
Component wise breakup
S.no Component Forest Land(ha.) Non-Forest Land(ha.)
1Road2.3451.155
2Muck Disposal0.07990
Total 2.4249 1.155
C. Maps of forest land proposed to be diverted
Division 1. : Bageshwar
  (i). Area of forest land proposed to be diverted(in ha.) : 2.425   (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.
1.2.425    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): 3   (iii). Temporary Employment(Number of person-days): 100
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. : Bageshwar
  (a). Village: Dulam   (b). Area(in ha.): 4.85   (c). Copy of KML file of the patch:     View File   (d). Khasra details: 1   (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
1objection 23.08.2017 removed by EE latter No- 2599/2EVB, Dt. 10.10.2017
2objection 28.12.2016 removed by EE latter No 182/2EVB, Dt. 21.01.2017, Hard Copy Recived by Nodal 30.01.2017
3objection 27.03.2017 removed by EE Latter No 1597/2EVB, Dt. 10.07.2017, Hard Copy submitted by Nodal Dehradun Dt. 13.07.2017
4Short narrative
5G.O.
6Joint Inspection
7Both alignment or alternative site
8Certificate from the DM that no alternative suitable non-forest land
9Land Schedule
10Category wise
11Bar chart
12scheme in civil and soyam land
13comensatory afforestation by DFO
14undertaking by the user agency
15Road side/gap filling plantation estimate
16undertaking by Road side/gap filling plantation
17Details of the trees
18Felling of oak trees
19certificate of felling minimum trees during the project work
20Muck Disposal scheme
21Whather project area is a part of National Park
22Please find the attached acknowledgement slip of receipt of hard copy at DFOs office.
23CCF wild life has to be provided
24Permission of Hon'ble supreme court/MoEF GoI.
25FC Act. 1980 reg.
26NOC from local Gram Sabhas.
27work has not been started reg.
28Geologist Report
29Task Force report
30Standard condition
31certificate geologist report/task force
32No historical/monumental
33No animal will be effected adversely by the project.
34provide alternative fuelwood, kerosene or LPG to labours involved in project.
35Benefited villages
36NPV Calculation certificate
37undertaking of payment of NPV
38Fact Sheet
39objection 02.09.2016 removed by EE Latter No 2350/2EVB, Dt. 17.10.2016