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/UP/NCP/64838/2016    ii. MoEFCC File No. : 2652/SPO-V    iii.Short narrative of the project: Proposed Residential Complex at Plot No. 04/BS – 02(GH-03) Siddhartha Vihar, District -Ghaziabad, Uttar Pradesh    iv. Project Sector : New Construction Projects and Industrial Estates    v. Company/Proponent : APEX HEIGHTS PVT LTD

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Uttar Pradesh	Ghaziabad	Ghaziabad

   vii.Date of TOR Granted 28 Jun 2017 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 05 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: 06 Jul 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: NIL

Additional Attachments, if any
S.no.	Attached File	Date of Submission
1.	Annexure Conceptual Plan	05 Jun 2017
2.	Annexure Form1	05 Jun 2017
3.	Form 1 Last page	05 Jun 2017
4.	Annexure Form 1A	05 Jun 2017
5.	Annexure ToR	05 Jun 2017

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : 12    iii. Name of Consultant: Ascenso Enviro Private Limited   iv. Address : D-79, Second Floor, Sector-6, Noida   v. Mobile No.: 8130498929   vi. Landline No.: 4333226   vii. Email Id: ceoapex4@gmail.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 : Rajendra    ii. Designation : CEO    iii. Name of Company(Applicant Name should not be given here) : APEX HEIGHTS PVT LTD    iv. Address : 11/3, Apex Acacia Valley, Sector-3, Vaishali, Ghaziabad, UP 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