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/71110/2017    ii. MoEFCC File No. : NIL    iii.Short narrative of the project: NIL    iv. Project Sector : INFRA-2    v. Company/Proponent : PROJECT DIRECTOR AND SUPERINTENDING ENGINEER KHARLAND DEVELOPMENT CIRCLE THANE

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
2.	Maharashtra	Sindhudurg	Kudal

vii. Uploaded EC Compliance report by rigional office of MoEFCC: Annexure-Uploaded EC Compliance report viii. Certified Monitoring report by RoMoEF: Annexure-Uploaded Monitoring report    ix.Date of TOR Granted N/A ix.Date of Submission for EC: 18 Dec 2017 x.Project Type: Expansion

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: 28 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: Data of Previous Clearance has been attached.

Additional Attachments, if any
S.no.	Attached File	Date of Submission
1.	MCZMA recommendation to MoEFCC	22 Nov 2017
2.	Compliance Letter to MoEFCC	22 Nov 2017
3.	Sarambal CRZ superimposed map	18 Dec 2017
4.	Mondpar CRZ superimposed map	18 Dec 2017
5.	Jamsande CRZ superimposed map	18 Dec 2017

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : NABET/EIA/1619/RA 0029    iii. Name of Consultant: Terracon Ecotech Pvt. Ltd.   iv. Address : 202, Kingston, Tejpal Road, Vile Parle (East), Mumbai-400057   v. Mobile No.: 7718811805   vi. Landline No.: 02226183939   vii. Email Id: kldcthane@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 : Ashok    ii. Designation : SE    iii. Name of Company(Applicant Name should not be given here) : PROJECT DIRECTOR AND SUPERINTENDING ENGINEER KHARLAND DEVELOPMENT CIRCLE THANE    iv. Address : 4th Floor, Sinchan Bhavan, Bara Bunglow Area, Kopari, Thane (E) 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