PART-I & II (Form for seeking recommendation of Standing Committee of

NBWL/SBWL)

Sl. No. 1 to 13 is covered in CAF

14 Whether proposal is for investigation/survey? [Yes/No] Drop Down
If Yes, then
14.1 Purpose for the investigation/ survey #Free Text#
14.2 Location and Map (1:50000 scale) of the area duly Upload
authenticated by the competent authority to be
investigated/ surveyed
14.3 Whether investigation/ survey involves destruction, Drop Down
exploitation or removal of any wild life including forest
produce from National Park/ sanctuary or destruction or
damage or diversion of the habitat of any wild animal by
any act whatsoever or diversion, stoppage or enhancement
of the flow of water into or outside the National Park/
sanctuary under section 29 or 35 (6) of Wild Life
Protection Act, 1972 [Yes/No]
If yes then
14.3.1 Specify the time required and extent of Physical
disturbance needed within the Protected Area like
tree cutting, earth work etc.
14.3.1.1 Extent of physical disturbance needed Drop Down
within the PA [tree cutting/ earth
work/ others (please specify)]
14.3.1.1.1 If Tree Cutting, then # Number#
No. of trees proposed to
be cut
14.3.1.1.1 If earth work, then # Number#
Earth Work (in Cu m)
14.3.2 Time Required # Number#
14.3 If no, then form submits here (with undertaking)
15 Upload a copy of note containing justification for locating the Upload
project in protected area
16 Category of the project [1. Airport 2. Approach Access 3. Borehole Drop Down
Prospecting 4. Communication Post 5. Construction / Widening of Road
including approach road to roadside establishments including bridges 6.
Defence 7. De-reservation / De-notification 8. Dispensary/Hospital 9.
Drinking Water 10. Forest Village Conversion 11. Government approved
Community Toilets 12. Hydel 13. Industry 14. Irrigation 15.Mining /
Quarrying 16. Non-Conventional Source of Energy 17. Optical Fibre
Cable/ Tele-communication Line 18. Petrol Pump 19. Pipeline 20. Police
Establishment like police stations / outposts / border outposts / towers in
sensitive areas (identified by MHA) 21. Power Sub Station 22. Power
Transmission Line 23. Prospecting 24. Quarrying 25. Railway 26. School
/ Educational Institution 27. Skill Up-gradation / Vocational Training
Center 28. Solar Power 29. Thermal 30. Village Electricity 31. Water

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 Mill 32. Water / Rainwater Harvesting Structure 33. Wind Power 34.
Others (please specify)]
In case of 1. Drinking water 2. Power Transmission Line 3. Optical
Fibre Cable / Tele-communication Line below fields need to be enabled
16.1 Select [Above ground/ Below ground/ Both] Drop Down
If below ground, then
16.1.1 Whether the project is proposed within the Right of Drop Down
Way [Yes/ No]
If Power Transmission Line> Below ground selected, then one more
additional field need to be asked
16.2 Select [More than 11 KV/ Less than 11 KV] Drop Down
17 Category of area required [Wild Life Sanctuary, National Park, #Checkbox#
Tiger Corridor, Tiger Reserve, Eco Sensitive Zone]
Whether the proposal require approval of Central Government under
the Forest (Conservation) Act
18 Whether any proposal seeking prior approval of Central Drop Down
Government under the Forest (Conservation) Act for diversion of
forest land required for this project has been submitted in the past?
[Yes/No]
If Yes, please provide details Fetch from DB in case of the
proposal is of post 2014 on
select option
18.1 Status of the proposal Drop Down
[The proposal submitted and under process / Stage-I FC Granted /
Stage-II FC Granted]

If Project ID / Proposal No. exists, then auto fetch below

mentioned details

Else all the details need to be fed

In case of Stage-II FC Granted
18.1.1 Proposal No. / Project ID #Free Text#/ #Search#
18.1.2 Proposal Name #Free Text#/ #Auto
Fetch#
18.1.3 MoEFCC File No. #Free Text#/ #Auto
Fetch#
18.1.4 Area proposed for diversion (ha) #Number#/ #Auto Fetch#
18.1.5 Area Diverted (ha) #Number#/ #Auto Fetch#
18.1.6 Date of in-principle approval Date Stamp#/ #Auto
Fetch#
In case of Stage-I FC Granted
18.1.1 Proposal No. / Project ID #Free Text#/ #Search#
18.1.2 Proposal Name #Free Text#/ #Auto
Fetch#
18.1.3 MoEFCC File No. #Free Text#/ #Auto
Fetch#

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 18.1.4 Area proposed for diversion (ha) #Number#/ #Auto Fetch#
18.1.5 Area recommended for diversion (ha) #Number#/ #Auto Fetch#
18.1.6 Date of in-principle approval Date Stamp#/ #Auto
Fetch#
The proposal submitted and under process
18.1.1 Proposal No. / Project ID #Free Text#/ #Search#
18.1.2 Proposal Name #Free Text#/ #Auto
Fetch#
18.1.3 MoEFCC File No. #Free Text#/ #Auto
Fetch#
18.1.4 Area proposed for diversion (ha) #Number#/ Auto Fetch#
18.1.5 Date of application Date Stamp#/ #Auto
Fetch#
+Add rows in case of the
diversion taken in piecemeal
19 Location of project /activity with respect to Protected Area
* (Protected Area: For the purpose of this Process, Protected area
means area falling under National Parks, Sanctuaries, Tiger
Reserves and Tiger Corridors. Non-Protected Area is the area
outside Protected Area & ESZ)
19.1 Location of Project Area [Completely located in Protected Drop Down
Area / Completely located in ESZ / Partially in Protected
Area and partially in ESZ/ Partially in Protected Area &
partially in Non-Protected Area / Partially in ESZ and
partially in non-protected area/ Others (please specify)]
20 Detailed breakup of land required for the project
20.1 No. of Divisions involved in Protected Area (Nos.) # Number#
20.2 Division Drop Down

PARIVESH Division Names.pdf

20.3 No. of Patches/ Segments #Number#
20.4 Upload single KML of all the patches/ segments for the Upload
selected division
20.4.1 Division wise breakup of land required
Nam Name Name Project area inside Protected Area/ Tiger Project area outside Protected Area (ha)
e of of the of the Reserve
the Divisio prote
Distr n cted
ict area/
Tiger
Reser
ve
Drop #Free Forest land Non-Forest Sub-Total Forest land Non-Forest Sub-Total
Dow Text#
PARIVESH_Divisions. (A) land (B) [X] = (A) land (B) [Y] =
pdf (A)+(B) (A)+(B)
n

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 Drop #Number# #Number# #Number# #Number# #Number# #Number#
Down

+Add rows

Total
20.4.2 Component wise breakup of land required
20.4.2.1 In case of Non Linear project
Patch No. Compon Name of Project area inside protected Project area outside protected Total
ent the area (ha) area (ha) area (ha)
Protected
Area
#Auto #Free #Free Forest Non- Sub- Forest Non- Sub-Total [X]+[Y]
land (A) Forest Total [X] land (A) Forest [Y] =
generate# Text# Text# land (B) = land (B) (A)+(B)
(A)+(B)
#Numbe #Numbe #Numbe #Numbe #Numbe #Number# #Number#
r# r# r# r# r#
+Add
rows
Total
20.4.2.1 In case of Linear project
Segment Compon Name of Project area inside Protected Project area outside Total
No. ent the Area (ha) Protected Area (ha) Area (ha)
Protected
Area
#Auto #Free #Free Length Width Area (ha) Length Width Area [X]+[Y]
(Km) (Km) [X] (Km) (Km) (ha) [Y]
generate# Text# Text#
#Number# #Num #Numbe #Numbe #Numbe #Num #Number#
ber# r# r# r# ber#
20.4.2.1.1 Provide animal passage plan* Upload

in case of transmission line proposal only

20.4.2.1.2 Management plan for areas under transmission lines Upload
(Mandatory)
20.4.2.1 In case of Hybrid projects --- Both tables (Linear + Non-Linear)
20.5 Total period for which land is required (No. of Years) #Number#
20.6 Aerial distance of the project from the boundary of the #Number#
Protected Area (km)
20.7 Area under Protected Area (In Hectares)/Tiger # Number#
Corridor/Tiger Reserve/Eco-sensitive Zone
20.8 In case of Tiger Reserve, provide
20.8.1 Area in Core Zone (in hectares) # Number#
20.8.2 Area in Buffer Zone (in hectares) # Number#
20.9 No. of trees proposed to be cut #Number#
20.10 Scanned copy of the Geo-referenced map of the protected Upload
area prepared by using DGPS or Total Station (pdf only)
20.11 Copy of the Biodiversity Impact Assessment report (in Upload
case the proposal involves use of more than 50 ha. of
NP/WLS)

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 20.12 Information on the projects undertaken by the proponent Upload
agency in the past in Protected Areas
21 Cost-benefit analysis in terms of maintenance of carbon neutrality Upload
or increase in carbon sequestration*
22 Whether the Project requires Clearance under the Environment Drop Down
(Protection) Act 1986 (Environmental clearance)? [Yes/No]
If Yes, then
22.1 Status of Environmental Clearance [EC Obtained / Application Drop Down
submitted / Application yet to be submitted]
If Project ID / Proposal No. exists, then auto fetch below
mentioned details

Else all the details need to be fed

If EC Obtained
22.1.1 Project ID/ Proposal No. #Search#/ #Free Text#
22.1.2 Date of issue of environmental clearance : Auto Fetch/ #Date
Stamp#
22.1.3 MoEFCC / SEIAA File Number : Auto Fetch/ #Free Text#
22.1.4 Upload EC Letter (in pdf) : Auto Fetch/ Upload
IF Application Submitted
22.1.1 Project ID/ Proposal No. #Search#/ #Free Text#
22.1.2 Date of application Auto Fetch/ #Date
Stamp#
22.1.3 MoEFCC / SEIAA File Number : Auto Fetch/ #Free Text#
22.1.4 Status of application [Submitted recently / ToR Granted / Drop Down
PH Conducted / Under appraisal]
If Application Yet to be submitted
22.1.1 Reasons thereof #Free Text#
23 Sector specific details (Same as FC Form-A)- Not yet developed
24 24.1 Copy of Additional Upload
information, if any
24.2 Additional information, #Free Text#
if any
25 Undertaking
I hereby give undertaking that the data and information given in #Checkbox#
the application and enclosures are true to the best of my knowledge
and belief and I am aware that if any part of the data and information
is found to be false or misleading at any stage, the project will be
rejected and clearance given, if any, to the project will be revoked
at our risk and cost. In addition to the above, I hereby give
undertaking that no activity such as change in project layout,
construction, expansion, etc. has been taken up
25.1 Name KYC
25.2 Designation KYC
25.3 Company KYC

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25.4 Address KYC
25.5 AADHAR Based e-Signature eSign
25.6 Date System Generated

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