Siwani Water Services Division, Bhiwani Full title of the Project : Rehabilitation of Siwani Feeder from RD 175979 to 249150. File No. : Date Date of Proposal : 02-04-2012 Checking list serial number 08 Statement showing details of Forest Area Involved in the Proposal Sr. District Division Range/ Tehsil Khasra/Survey Non Forest Present Remarks No. Village or compartment Area involved land use Number or Km in the (Ha). stone 40000 km proposal (Ha) to 49702. 1 2 3 4 5 6 7 8 1 Bhiwani SWS Daya, Bhari, Siwani Feeder 13.56 Ha. Right Side Divn., Harita, from RD bank of Bhiwani Talwandi 176150 to Siwani Rukka, Dabra 249150. Feeder. to Saharwa Tehsil Hisar Date : __________ Forwarded by Place : __________ Executive Engineer, Siwani W/S Divn, Bhiwani -dk- Siwani Water Services Division, Bhiwani Full title of the Project : Rehabilitation of Siwani Feeder from RD 175979 to 249150. File No. : Date Date of Proposal : 02-04-2012 Checking list serial number 11 Certificate for minimum use of Forest Land This is to certify that the forest area involved in the proposal in unavoidable and forest minimum i.e. 13.56 Ha which is proposal diversion. Date : __________ Executive Engineer, Siwani W/S Divn, Place : __________ Bhiwani -dk- Signature of User Agency. Countersigned. Siwani Water Services Division, Bhiwani Full title of the Project : Rehabilitation of Siwani Feeder from RD 175979 to 249150. File No. : Date Date of Proposal : 02-04-2012 Checking list serial number 12 Undertaking for payment of cost of compensatory afforestation I Sohan Lal Bhati, Executive Engineer, Siwani Water Servics Division, Bhiwani is hereby undertake to pay the entire amount of compensatory afforesatating in lieu of the for 13.56 Ha area diverted for Rehabilitation of Siwani Feeder from RD 175979 to 249150 right side village Dabra to Saharwa, Tehsil & District Hisar as per the prevailling wage rates at the time of undertaking the plaintation activities. Date : Executive Engineer, Siwani W/S Divn, Place : Bhiwani Bhiwani -dk- Signature of User Agency. Officer Seal Counter Signed by:- Siwani Water Services Division, Bhiwani Check List Serial No.13. Undertaking for payment of net present value of Forest Area It is to certify that Siwani Water Services Division, Bhiwani have applied for diversion of 13.56 Ha of Forest area for the purpose of Rehabilitation of Siwani Feeder from RD 175979 to 249150. I/We, hereby, undertake to pay the net present value (N.P.V.) of the above land. Date : Executive Engineer, Siwani W/S Divn, Place : Bhiwani Bhiwani -dk- .