PART I
Proposal for Investigation and Survey in the National Park
(Details to be pro'r.ided by the App[cant)
/
Sanctlrarv
1. Nanre oithe Organizarron
2
Ainrs rmcl Objectives of the Proposecl Projecr.
3. Locarion
and t\[ap (1:50,000 sca.le) of dre atea duly aut]renucated by the co,r-]petelrt
authoritv to be inr-esri5;ated/ sut'r e1'ed
4
\X/hether rnvestrgatron/sLrn.ey requircs clcating of vegetatron
5.
1f yes, pleasc specity the extent (in I{a.)
6. Oprnion of dre Offrcer In
i.
(-harge of rhe
NP/
\X/l,S (Attach signecl cop/)
Opinion of t.[re C]iief Wrldlife Warder: (Atrach srgned cc,py), The followrng be
includecl rn the opurion:
r)
u)
Lul
rr.)
v)
\'1)
Signed
I-Iead
Nanre
Projecr-
Ctr:grnizeuon
Brief ]ristory r-,1: thc p,rotectccl arca
Current statlrs of ri,ildliie
(,urrcnt statLls oI pressures on protect"ed
ar-eas.
Projecrecl impact.s of prc-rjects on u,ilcihfe, hnbitat rlraflag^elnent ancl
access/ rr-\e of resc)ltrc:e $y variorrs stal<eholclels
Conu$rous uald[fe areas u,hich r',,oulcl benelit u,j]d[fe if addecL to
n auon al parlc/ sanctuary.
Other areas in the Stare ri.hich have been recomlnended b,v State.
Gcivernnrenl Wildhfe Insutr-rte of lnd-ta, BNI--1S. Sr\CON, IISC,
ILICN ot oLher expert body for inclusion ur protected area ncfit,orir.
Signecl
Srsned
'fhe Oflicer ln Charge r:l the Nl']/
Office Se:rl
\X/I-S
'Ihe Clill-\Xi
Offrce
Se'al
PART II
(To be filled in by the Applicant)
i
Proiect detzuis:
(,
Copy of the Investigation and Suruev report.
(The rcport. should inclucle the clates of survey and rhc names of the
investigators, sulveyots and all oificials of the concerned NP/ WLS rr,'ho
rernained prcsent during the pcriod)
(ti)
Self cor:tained and facnral prr:iect report fcrr which NP/WLS area is
reqrured
Enclose copv oi the Proicct App&Usaklecumend
2
(r1)
I\,Iap (dulv authenticated by dre Divisional / Disttrct Head of the
Department dealing u,ith Fotests and Wildlife) on a scale of 1: 50,000
shou,ing the bounclaries of the NP/WLS, clelineating the area in question
in red color).
(ir.)
Self contarned and facrual rcport of at lcast tq,o alternatives considered
by the project rruthotities along with technical and financial iustification
for optu:g nauonal parl</ sanctuary area.
(r,
Copy of thc Bio diversity Impzrct Assessment report in case the
proposal invohres diversion of more than 50 ha. NP/\X{"S alea.
l-ocation of the project/scheme
(, State/Unjon T'erritorl,
(r) District
(ui,t Nzrme of the National Parl</ Sanctuary
3
Details oi'the
are a
required (in Hectares only)
9
fProvide ]:re.ak r-rp of the land use under t]re projecr, e.g., consuuction of danl
submcrgence, housirre tbr staff, road etc)
4
5
Detai.ls of drspJacenrent of peopJe,
if
any, due ro the project
(r)
(ii)
Total number of families invoh.'ed in dispJacement
Number of scheduled caste/Scheduled tribe fan:ilies invoh,ed in
(ii,)
dispiacement
Derailecl rehabiJjratir:n p)an
r\ny odrer infornration reJevant to the proposal but not covered tn any of the
colunrns above.
Signed by
Project l-Iead
Nan-re
Organizatir:n
Date of sLrbnrission to rhe I-lead of the Nauonal Par:k
/
Sancnrarv
IU
PART
III
(To be completed by the Officer -in- Charge of the Natio nal Park/
Sanctuary completed and submitted to the Chief Sfild Life \Warden or
officet authorized by him in this behalf q'ithin 30 da1,s of the receipt of
PART - rr)
.l
Date of r:eceipt of rhe PAR:I'-
il
2
Total Area (Ha.) of r:ational par:k/sanctuary
3
Total area (I-{a.) diverted from the NP/\X,TS so far for development putposes
4
List the past pro.iects and the area (I{a.) diverted
Name of
5
Pr:oject
Diverted
Area
Year of Diversion
Positive impact(s) due to the divetsior: of area for the projecrs referred
to in coh-u:rn 4 above
Name of the
Project(s)
(r\tt.adr s(:parate sheet,
(r
Impact
Scientific Basis of Assessment
if required)
Negauve impact/s due to the diversion of area for the projects referred
to in column 4 above
Natne of dre
Proje.ct(s)
qr\ttach separate sheet.
7
Positive
if
Negative
Lnpact
Scicndfic Basis of Assessrnent
r:e:quired)
tr4anagement Plan Period
.\trach copy oi the iVlanagement Plan/N,Ianagernent Scheme/ Recommendation of
Chief Wildlil'e Warden
8
List Management actions taken/ proposed to be taken in the rvhole Bloch/
Zone.iit which the proposecl area is locatecl.
9
Tg:e of forest in u4rich the proposed area falls.
11'
10
l-ocadon oi'dre proposcd aleiir \\/.r.t, the cntical/lntensl\/c rvildhfe nlanagement
ue'asf wildljfe habitats (attach l\,lap to scale).
l1
I-.ist the Iikely
POSI'fIVti AND NJrCIAT'IVE rrnpact/s of the ptoposed
projecr gir,rng scientjllc and techntcal jr,rstificauon fcrt cach unpact.
12
Provlde COI,IPITEFENSrVE clerails of the irnpact c.;f the proposal in terrns of
Sections 29 enclf or section 35 (6) of thc \\/rld Lifc r?rotectior-r) :\ct, 1912 as the case
nray be.
13 Whe.ther: thc projcct aurhorrues havc cr-c: cornmrtrcd vioi:rtion of the \X/ild l-itc
(Prr-rlecuon) Act, I972 or liorest Conservalron Act, 1980. If ves, provrcle dre
EXI-L{UST1v-1-i details of dre: ,:ffence and dre present statLrs of tirc case.
(Concealing or nrrsrepresenung the tacts uall lead to rejecnon of t.he case in addjuon
ro any c-rdeer penalry as presctibed r-rnder Lar,r)
14
Have yr,rL: exanriled thc Project r\ppraisal docunrent ancl dre alternadr.es
provided in PAI{T'- Ili
15
16
as
Harre you exan:inecl dre Bio cliversity lnrPrlct Assessrnenr.l{eport?
If Yes, please gir.e your: conxller-lts on Lhe 1'ecornlrenclations
gr\ren irr
fie
Iepor:t?
17 I)ates ar:d duration of your llelcl r,rsrts ro r.ile proposecl sire.
18 I)o y,ou aglee that dre present propr-,sa1 r-rf drversion of NPi\{iLS area is dre
l-rcst
or the only option
ar-rd
is r.rable.
19
Any other infolrnauorr that youi rvould hke to bnr-rg to dre nonce c'if the State
Board fr,rr Vitldirfe. Nauonai Board fbr Wildlite or its Standing Conunrttee dlat may be
relevanr arrd assist in decrsign makrng.
20
I)o
yor.r
7P/eu:c
lecomflrend dre project
prouilt.fulljustzlicatlon lo sttppotTlor.tt rr:iottrneadaliou.r.)
Sr,qned by
T'he Offlcer
In Ch:uge of
the
NP/
Ofhciai Seal
Date of submission to thc Chief
hinr rrr this legard
\Xry,S
\X/11d I-if-e
\Xiarden or an\,; odrel ofiicer ai-Ldrorized bv/
12
PA R"T
IV
(To be completed by the Chief Wildlife Warden within
PART - II and Part- III)
1
1.5
days of the teceipt
of
Dare r.rf R[lCE]P'I' of PART- II and i)art- ill by tire Clief \Xiild I"ife \\'arden c,r
the officet aLrlltotizcci by hirl in this regard
2 Do you agree rvith dre inlonnauotr
Ofhcer - in - Charge rn PAR'1'- II1?
and recomlnendatic,ns prortded
liy
t1"re
3 If not. please prowide the reasons
4
Flar.e you rrisited the site ),ourself and ireld drscr-rssions
5(r)
I)o you
5(b)
\4retl-rer the proposal sr-:b-jr-rdice?
with the appLcant?
aqree drat the ptesent proposal ibr permining use
area is dre best option or the onlv option, and is rriablc?
If
ycs, give details.
6
Please pror.ide speci{rc colllments n,.r.t. Secuon
(Protecuon) Act,1.9i2
7
r\ny
8
Do you l'ecommend the;rroject.'
29 of the W'ild Life
to the notice of the State
Board ftrr \X/i]dlile, Nadona-l Bc.rard firr \Xiilcllife or its Standing Cotnmittec that
may be relevant and assist irr decision rnalrrng
other: inform'.ttion that you 11,er:lcl lilre tr: brir-rg
Please pror,vdefu/ljasnf cahon to .r/./pqLrt_y\ltr
9
of NP/V'LS
re
rctnmendafions)
Conditrons, if an,v, to be ensured in the inter:est of plrotection zurd consr'rvtrtion
r,rf ri,rldLfe fol allowms use o1'tire aleai
Signed by
'l'he Chief Wildlife Warden
Nan-re
State
Offrcn] Seal
I)are oi subnlssion to rirc Siete G,-",..ernn'lent
13
ka''.
PART Y
(To be cornpletccl
b), thc Dcpartrnent in Charge of Forestrl, and Wild Lii'e in
consultation with the State Board for Wild Life rv'ithin 30 davs of the reccipt of
PART
- II, PART- III and PART- IV )
lll
I
Date of RECELll'1'of I?,{Rl-- II, PAR L- IIJ and
2
L)t: rrou a8'ree wrrh the recomrnenclauon(s) of the Clrie f \\iildlife Warcien
3
If nor,
1
Did ),ou provjcle PAIU|- lI, IIART- 11I and P,{R-f - lV to t}re membets of
pJease
RT - TV by the Deparrr:-rmt
provide the re.asons.
t}re
State Board
for Wilcl Life?
5
Attach copy of tire opinion of dre State Board for Wr-ld Ljfe
6
Gn,e detail.s of dre fecou-)1r-ienclations of dre State Governrrenl
Sie'nr,d by
T'he Pnncipal Secretary
Name
State
Oftrcial Scal
Date of submission to dre Centritl Clorrernment
1i
_t+