Form –“A”

(See Para 2.2 (i))

(To be filled up by the User Agency)

1. Project Details : Length of road 2.5 KM

Length of RF KM

i) Short narrative of the proposed/Scheme for: MGNREGS-Approach Road

which the forest land is required for
communication

ii) Details of the Forest land required : KM

(Two option to be indicated)

a) Location Survey No/Compartment No. :

b) Extent of the area (in hectare) : L x B = Total Sqm or Hectrs

x = or

c) Forest Division :

d) Map showing the required forest land, :

boundary of adjoining forest on a
1.50,000 scale map.

iii) Justification for locating the Project in : No other alignment than proposed
proposed forest land (s)______________

iv) Number of tress to be filled (Per hectare) : NIL

and number that will be kept standing