1.	Project Details

   Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? : No

1.	Project Details

   i. Proposal No. : IA/MH/MIS/63155/2017    ii. MoEFCC File No. : 11-15/2017-IA-III    iii.Short narrative of the project: Proposed star category Hotel “ At Village Munage (Sadewadi), Tal. Devgad, Dist, Sindhudurg Maharashtra    iv. Project Sector : INFRA-2    v. Company/Proponent : M/S KARVEER UNITED LEISURES PVT. LTD.

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Maharashtra	Sindhudurg	Devgad

   vii.Date of TOR Granted N/A viii.TOR letter issued by Ministry: N/A ix.Date of Submission for EC: 15 Mar 2017 x.Project Type: New

2.	Uploaded Documents of EIA/EMP,Risk Assessment,Public Hearing etc.

i.EIA/EMP: Annexure-EIA/EMP ii.Risk Assessment: Annexure-Risk Assessment iii.Public Hearing: Annexure-Public Hearing    iv. Date of Public Hearing: 09 Nov 2016   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: Annexure-Additional Report/Study/Document   vi. Uploaded Cover Letter: Annexure-Cover Letter   vii.Remarks: -

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA/1417/SA 0011.    iii. Name of Consultant: ULTRATECH   iv. Address : Saudamini commercial complex, building C3, 2nd floor paud road Kothrud Pune 38   v. Mobile No.: 0202528610   vi. Landline No.: 02025286106   vii. Email Id: bharati@ultratech.in

5.	Undertaking

I hereby give undertaking that the data and information given in the application and enclosures are true to be best of my knowledge and belief and I am aware that if any part of the data and information found to be false or misleading at at any stage, the project will be rejected and clearance given, if any to the project will be revoked at our risk and cost.

   i. Name of Applicant : Arun    ii. Designation : Director    iii. Name of Company(Applicant Name should not be given here) : M/S KARVEER UNITED LEISURES PVT. LTD.    iv. Address : G-1, MIDC, GOKUL SHIRGAON KOLAHAPUR v. Uploaded copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency: NIL