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/KA/MIS/67427/2017    ii. MoEFCC File No. : 11-30/2017-IA.III    iii.Short narrative of the project: Proposed Beach Resort Project at Beejadi Village, Kundapura Taluk, Udupi District, Karnataka    iv. Project Sector : INFRA-2    v. Company/Proponent : SUNIL SHETTY

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Karnataka	Udupi	Kundapura

   vii.Date of TOR Granted N/A viii.TOR letter issued by Ministry: N/A ix.Date of Submission for EC: 19 Aug 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: 12 Jun 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: NIL

Additional Attachments, if any
S.no.	Attached File	Date of Submission
1.	Recommendation Letter from KSCZMA	19 Aug 2017
2.	CRZ Map 1:4000 Scale	19 Aug 2017

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA/1518/RA014    iii. Name of Consultant: METAMORPHOSIS Project Consultants Pvt Ltd   iv. Address : PRAKRUTHI BHAVAN, #200, 2nd Floor, 1st Cross, 40th Main, BTM Layout 2nd Stage, Bengaluru-560068   v. Mobile No.: 9845027475   vi. Landline No.: 08026783006   vii. Email Id: mdrnsmaruti@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 : Sunil    ii. Designation : ManagingDirector    iii. Name of Company(Applicant Name should not be given here) : SUNIL SHETTY    iv. Address : No. 301, Sterling Orchads, Opposite to Air Force School, C.V.Raman road, Sadashivanagar, Bengaluru 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