, APPENDEX (See Rule 6) . FORM_.A' Form for seeking prior approval under section 2 of the proposats by the state Government and other authorities PART.1 (TO BE FILLED BY USER AGENCY) 1. Project details: I Short narrative of the Construction of tift Irrigation Scheme on Guthpa proposal and project/ balancing scheme for which the tank Guthpa(V), Merkloor(M), Nizamabad forest land is District. required The alignment of pipe passes throdghr forest lands of 0.176 Ha at certain stretches. Now it is proposed to submit the proposals for diversion of 0.!.76ha forest land for construction of Lift Irrigation scheme on Guthpa balancing tank Guthpa(V), Makloor(M), under F@Act,1980.

The Present Proposal: constructiron of Lift rrrigation Scheme on Guthpa batancinrg tank Guthpa(V), Makloor(M), Nizarnabad District.

MAIN COMPONENTS oF THE SCHEII,IE:

construction of Pump house and Delivery cistern, Laying of MS pipes etc.

Pressured pipe of MS in the Forest and extent of forest land required is as follows:

Area Division Required Block Name Length width Name in Hectares Forest Mamidipally-ll t467.L3 1.20 0.176 v Division Total t467.t3 0.t76 "

Detailed note on the project enclos;ed. construction of Lift rrrigation scheme on Guthpa balancing tank Guthpa(V), Makloor(M), Nizamabad District consists of O.176 ha. ii Map showing the Map showing the reselve forest and adjacent forest is required forest land, boundarY oi enclosecl' adjoining forest on a The DGPS Survey data map authenticated by the Forest 1:50,000 scale map. *_F_ Department enclosed. -"t" iii Cost of the project 23.80 croreY' IV Justification for locating project the a) Many alternative alignments for this proJect are worked in forest area out in order to minimize the irrvolvement of forest land. The present proposar is finarized with a minimum total diversion of forest rand of about 0.176ha coverd in MS pipe of 550 mm dia.

b) This project proposals do nort involve

. Any places of hlstorical, religious, archaeological, recreationa I importanc€.

o Total diversion of forest area of 0.176ha is required for this project i.e. construction of Lift Irrigation scheme on Guthpa balancing tank Ciuthpa(V), Makloor(M), Nizamabad District.

Detailed note on the project enclosed.

V Cost-benefit analysis The benefit-cost ratio (Not Applicable), vi Employment likely to 1. (Not Applicabte). be generated 2. By proviciing water to tanks for irrigatio n of 2642 acres in Nizamabad district.

2. Purpose-wise After working out various alternative Alignments, the diversion break-up of the of forest land to the mlnimum requii-ernent is uiorked out. This total land required. forest land is proposed to be utirized for pressure main, power lines and water conveyance of this project for the benefits mentioned above.

3. Details of displacement of people due to the project, if any:

I Number of families. ii Number of Scheduled Casts/ Scheduled Does not arise aEJhere are no diisplacement )@ of the Tribe families. people for the proiect. Rehabilitation plan (To be enclosed) 4. Whether clearance (Not Requiredl) under Environrnent (Protection) Act, 1986 required? (Yes/No) 5. Undertaking to bear the cost of raising and maintenance of compensatory afforestation and/or penal compensatory afforestation as well Enclosed. as cost for protection and regeneration of Safety Zone, etc., as per the scheme prepared by the State Government

Details of * Justification for locating the project inside the Forest Land Certificates/ * Undertaking for depositing the funds towai.ds raising and 6. documents maintenance of Compensatory afforestation. enclosed as required Undeftaking for depositing the funds towards payment of Net Present Value (NPV) and Additiohal NpV. under the Undedaking instructions. fo:' depositing the funds towards paymerrt of extraction of tree groMh. * Certificate of Area Minimum.

* Detailed statement requirement of fbrest tand"

* Map in SI sheet showinE the forest lland .:. DGPS survey data for forest land proposed for diversion as well as CA land.

a List of CA lands identified and map:;

":. certificate for non-violation of Forest (conservation) Act, 1980...... etc [-' .t se)> w)r Dy. Executive Engineer E: ecu ngineer Project Sub-Division, Projects Division, . $P,