APPENDIX VIII (See paragraph 6) FORM 1 M APPLICATION FOR MINING OF MINERALS UNDER CATEGORY ‘B2’ FOR LESS THAN AND EQUAL TO FIVE HECTARE.

Basic Information

(i) Name of the Mining “Granite Building Stone Quarry of Mr.Rajan” Lease Site

Re-Survey No:- 111/1A1A Village:- Koothali Taluk:- District:- State:-

Pillar No Latitude Longitude

BP 01 11°35'21.30"N 75°46'26.30"E

(ii) Location/Site (GPS Co- BP 02 11°35'20.70"N 75°46'27.50"E Ordinate) BP 03 11°35'21.10"N 75°46'27.50"E BP 04 11°35'22.20"N 75°46'27.70"E BP 05 11°35'22.90"N 75°46'28.50"E BP 06 11°35'24.60"N 75°46'28.40"E BP 07 11°35'24.80"N 75°46'27.90"E BP 08 11°35'23.60"N 75°46'25.60"E

(iii) Size of the Mining 0.6551Ha Permit (iv) Capacity of Mining 31377.5MT Permit (v) Period of Mining 5 Years Lease/Permit (vi) Expected Cost of 25,00,000 Project

Name Mr.Rajan Address S/o Krishnan Nair (vii) Contact Information Puthiyottil House Kodiyangad Post Kozhikode-673525 E-mail Mob +919745507011

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Environment Sensitivity

Si No Areas Distance (KM) Distance of project site from Rail, Road Bridge over Koyilandy Road Over Bridge-23 KM 1 the concerned River, Rivulet, Nallah etc. 2 Distance from infrastructural facilities Railway Line Koyilandy-25KM National Highway NH-17-24KM State Highway SH-38-1KM Major District Road Koothali Road-500M Other Road Koothali Mangotti Road-100M Electrical Transmission Line or Pole Poovara-100M Canal/Check Dam/Reservoirs/Lake/Pond Peruvannamuzhi DAM-7KM In-take for drinking water/pump house Peruvannamuzhi-7KM In-take for Irrigation canal pumps Peruvannamuzhi-7KM Areas protected under international conventions, 3 national or local legislation for their ecological, None within 1KM from project site landscape, cultural or others related value. Areas which are important or sensitive for ecological Kadiyangad River-3KM reasons – Wetlands, watercourses or other water Vadakara Coastal Area -22KM 4 bodies, coastal zone, biospheres, mountains, Koyilandy Coastal Area -22KM Muthukad Mountains-2KM Peruvannamuzhi Mountains-7Km Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, None within 1KM from project site 5 foraging, resting, over Wintering, migration 6 Inland, coastal, marine or underground Vadakara Coastal Area -22KM Waters Koyilandy Coastal Area -22KM 7 State, National boundaries State Boundary-50KM Routes or facilities used by the public for access to Peruvannamuzhi-7KM 8 recreation or other tourist, pilgrim areas Janaki Forest-5KM 9 Defense installations None within 1KM from project site 10 Densely populated or built-up area, distance from 50M toward South West side from the nearest human habitation area Areas occupied by sensitive man-made land uses Hospital:-Gov.Hospital -3KM 11 (Hospitals, schools, places of worship, community Airport:-Calicut Airport -56KM facilities) School:-Koothali AUP School -1.5KM Church:-St.Antony’s Church -4.80KM Mosque:-Umarul Farooq -2KM Temple:-Koothali Mahavishnu Temple- 1KM,Kokkad Shiva Temple-1.8KM

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Areas containing important, high quality or scarce Peruvannamuzhi-7KM resources (ground water resources, surface resources, Janaki Forest-5KM 12 forestry, agriculture, fisheries, tourism, minerals)

Areas already subjected to pollution or environmental damage, (those where existing legal environmental No 13 standards are exceeded)

Areas susceptible to natural hazard which Could cause the project to present environmental problems (earthquake, subsidence, landslides, No 14 erosion, flooding, or extreme or adverse climate conditions) is proposed mining site located over or near fissure/fracture for ground water recharge Whether the proposed involves approval or clearance under the following Regulations or Acts namely:-

(i) The Forest (Conservation) Act, No 1980; (ii) The wildlife (Protection) Act, No 15 1972; (iii) The Coastal Regulation Zone Not Applicable Notification, 2011

If yes, details of the same and their status To be given.

16 Forest land involved (hectares) No forest land involved Whether there is any litigation pending against the project and/or land in which The project is proposed to be set up? No (i) Name of the Court 17 (ii) Cash No. (iii) Orders or directions of the court, if any and its relevance with the proposed project

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“I hereby given undertaking that the data and information given in the application & Enclosures & true to the best of my knowledge & belief & I am aware that if any part of the Data & information submitted is found to be false or misleading at any stage, the Project will be rejected & clearance gives, if any to the project will be revoked at our risk & cost”.

Signature of Proponent:-

Dr. Nazar Ahamed K.V DMG/KERALA/RQP/07/2016 Name: - Mr.Rajan

Address: - S/o Krishnan Nair Puthiyottil House Date: 08.10.2018 Kodiyangad Post Place:Kozhikode Kozhikode

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