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/GJ/MIS/64048/2017    ii. MoEFCC File No. : NIL    iii.Short narrative of the project: Dandi - The Leisure and Entertainment World    iv. Project Sector : INFRA-2    v. Company/Proponent : Hitarth Developers LLP.

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Gujarat	Navsari	Jalalpore

   vii.Date of TOR Granted N/A viii.TOR letter issued by Ministry: N/A ix.Date of Submission for EC: 26 Jun 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: 04 Apr 2017   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: This application is for CRZ Clearance only.

Additional Attachments, if any
S.no.	Attached File	Date of Submission
1.	Form I - CRZ	26 Jun 2017
2.	CRZ map for LTL and HTL details	26 Jun 2017

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA/1414/SA 2 002    iii. Name of Consultant: ECO CHEM SALES & SERVICES   iv. Address : ASHOKA PAVILLION-A, OFFICE FLOOR, OPP. KAPADIA HEALTH CLUB, NEW CIVIL ROAD, SURAT   v. Mobile No.: 9227934111   vi. Landline No.: 02612231630   vii. Email Id: ashokmdalal@yahoo.com

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 : Ashok    ii. Designation : CEO    iii. Name of Company(Applicant Name should not be given here) : Hitarth Developers LLP.    iv. Address : Block No: 610, 612, 620, 630, 632, 634, 644, 649, 652, 655, 657-A, 657-B, 664 to 666, 668, 670, 672, 674 to 687, 691, 692, 696, 697, Vill: Dandi, Tal: Jalalpore, Dist: Navsari 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: Annexure-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