APPENDIX I
(See Paragraph-6)
FORM 1M
Note : If space provided against any parameter is inadequate,Kindly upload supporting document under 'Additional Attachments if any'  at the last part of the Form 1M. Please note that all such Annexures must be part of single pdf document.
(I)Basic Informations
S.No.Item Details
(i).Name of the Mining Lease site BUILDING STONE & MANUFACTURING OF M-SAND QUARRYING PROJECT
(ii).Location / site (GPS Co-ordinate) Boundary Points Latitude Longitude BP-A N13°34’48.8 E77°13’49.4 BP-C N13°34’49.0 E77°13’52.5 BP-D N13°34’42.6 E77°13’56.0 BP-E N13°34’41.2 E77°13’50.5
Annexure-GPS file      
(iii).
Type of LeaseIndivisual Area
Size of the Mining Lease (in ha.)2.833 ha.
(iv).Capacity of the Mining Lease (TPA) 150056
(v).Period of Mining Lease 20
(vi).Expected cost of the Project 60
(vii).
Have you hired Consultant/Registered Qualified Person(RQP) for preparing document?No
Reason for not hiring the Consultant/RQP due to financial constrraint
(II) Environmental Sensitivity
S.No Areas Distance in kilometer / Details
1. (i).  Nearest rail or road bridge over the concerned river,rivulet,nallah etc. in kms.  1.50 km
2. (ii). Nearest Infrastructural along with distance in kms  1.00 km
(iii). Nearest Railway Line along with distance in kms  50 km
(iv). Nearest National Highway along with distance in kms  12 km
(v). Nearest State Highway along with distance in kms  1.00 km
(vi). Nearest Major District Road along with distance in kms 1.00 km
(vii). Nearest Any Other Road along with distance in kms  1.00 km
(viii). Nearest Electric transmission line pole or tower distance in kms  0.20 km
(ix). Nearest Canal or check dam or reservoirs or lake or ponds distance in kms  0.90 km
(x). Nearest In-take for drinking water pump house distance in kms  1.50 km
(xi). Nearest In-take for Irrigation canal pumps distance in kms  0.00 km
3. Areas protected under international conventions, national or local legislation for  their ecological, landscape, cultural or other related value
No nearby protected areas.
4. Areas which are important or sensitive for ecological reasons - Wetlands, watercourses or other water bodies, coastal zone, biospheres, mountains, forests There are no wetlands, water bodies, coastal zone, biospheres within 5 kms radius.
5. Areas used by protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration There are no areas protected, important or sensitive species of flora or fauna for breeding, nesting, foraging, resting, over wintering, migration is involved for quarry area.
6. Inland, coastal, marine or underground waters Not applicable.
7. State, National boundaries There are no state, National boundaries within 10 kms from the quarry site.
8. Routes or facilities used by the public for access to recreation or other tourist,pilgrim areas Koratagere to Madhugiri Main road is about 1.0 km & connected to Madhugiri town by 12 kms & Koratagere about 08 kms from the quarry area.
9. Defence installations No defense installations near by the project site
10. Densely populated or built-up area, distance from nearest human habitation Tumbadi, 1,676 population, towards South-east side 1.00 kms.
11. Areas occupied by sensitive man-made land uses (hospitals, schools, places of worship,community facilities) Koratagere town is about 08 kms and is having Schools, temples, Places of Worship, Hospitals, Community facilities and Police station etc.,
12. Areas containing important, high quality or scarce resources.(ground water resources,surface resources,forestry,agriculture,fisheries,tourism,minerals) The subject Quarrying area is Govt. Gomala lands and contains building stone/rocky deposits.
13. Areas already subjected to pollution or environmental damage.(those where existing legal environmental standards are exceeded) Not Applicable
14. Areas susceptible to natural hazard which could cause the project to present environmental problems (earthquakes, subsidence, landslides, erosion, flooding or extreme or adverse climatic conditions) No Areas susceptible to natural hazard near the project site.
15.
Is proposed mining site located over or near fissure/fracture for ground water recharge?No
16.
Whether the proposal involves approval or clearance under the following Regulations or Acts namely?
(a).
The Forest (Conservation) Act,1980?No
(b).
The Wildlife (Protection) Act,1972?No
(c).
The Coastal Regulation Zone (C.R.Z) notification,2011?No
17.
Is forest land involved (ha)?No
18.
Whether there is any litigation pending against the project and/or land in which the project is proposed to be set up?No
19.
New/Expansion/ModernizationNew
Proposal NumberDIA/KA/MIN/11527/2017
File Number61/17-18
Date of Apply EC06 Dec 2017
Details of State of the project
S.No. State Name District Name Tehsil Name
(1.)KarnatakaTumkurKoratagere
(2.)KarnatakaTumkurKoratagere
(III) EC Attachments
1 Uploaded PFR (Pre Feasibility Report) File Annexure-PFR file
2 Uploaded Approved Mining Plan File Annexure-Approved Mining Plan file
3 Uploaded District survey report Annexure-District Survey Report
4 Uploaded Cover Letter Annexure-Cover Letter
Uploaded Additional attachments, if any
S.No. Attached File Date of Submission
NIL
(IV) Undertaking
The aforesaid application and documents furnished here with are true to my knowledge.
(IV).(i)
NameMUKTHANATHESHWARA STONE CRUSHER
DesignationApplicant
Company MUKTHANATHESHWARA STONE CRUSHER
AddressBinnamangala Village, Arishinakunte Post,
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