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Water Quality Impact Assessment (WQIA)

  1. General Project Information:

  2. Resource Protection Area (RPA) Information:
    Does the site contain any of the following (check all that apply)?

  3. Resource Management Area (RMA):
    Does the site contain any of the following (check all that apply)?

  4. Required Attachments:
    For individual residential lots:

  5. For site plans and subdivision plans:

  6. For any proposed development or redevelopment within a Chesapeake Bay Preservation Area (CPBA) which disturbs any portion of the RPA, the elements of a Major Water Quality Impact Assessment (WQIA) shall be submitted along with this form in accordance with City of Fredericksburg Code Section 72-34.5L.(2). The elements of a Major Water Quality Impact Assessment may also be required at the Stormwater Administrator’s determination due to unique characteristics of the site or the intensity of the proposed use or development. Encroachment or modifications may require the submittal of a buffer mitigation plan in accordance with the latest edition of the Riparian Buffers Modification and Mitigation Guidance Manual from CBLAD.

  7. For all exception requests, an exception request application shall be submitted along with this form in accordance with City of Fredericksburg Code Section 72-34.5J.

    The applicable stormwater criteria for this project is either Section IIB (Runoff Reduction Method) or Section IIC (Chesapeake Bay Preservation Act requirements). Please check the appropriate Technical Criteria used for this project:

  8. Section IIB:
    Is the project in Over 2500 SF and less than 1 acre?

  9. Is the project greater than or equal to 1 acre?

  10. If YES to either of the conditions above, runoff reduction and channel protection computations must be submitted with plans.

  11. Section IIC:
    Will the proposed development result in greater than 16% impervious cover?

  12. If yes, calculations and worksheets from the Virginia Stormwater Management Handbook for pollutant loading must be submitted with plans.

  13. For all BMPs required, submit the required design drawings and calculations for the BMP, a plan sheet clearly showing the location of all BMPs and inspection and maintenance requirements for all BMPs.

    The property owner must complete, sign and have notarized a City of Fredericksburg BMP Maintenance Agreement and appropriate easements based on the specific BMPS required.

  14. Please note that a construction record drawing, consistent with 9 VAC 25 870-55.D, will be required prior to release of project.

  15. Applicant's Information:

  16. Applicant’s statement for Water Quality Impact Assessment:

  17. I certify that I am a licensed professional in the Commonwealth of Virginia and that to the best of my knowledge, having completed a site-specific in-field evaluation and delineation of perennial flow, in my opinion the proposed development meets the requirements of the City of Fredericksburg Code, Section 72-34.5 Chesapeake Bay Preservation Overlay District.

  18. Applicant’s statement for Wetlands:

  19. I certify that I am a licensed professional in the Commonwealth of Virginia and that to the best of my knowledge, in my opinion the proposed development complies with the current requirements of section 404 of the Clean Water Act and state wetland regulations including the requirement that a wetlands delineation be performed and shown on the requisite plan.

  20. Applicant’s statement for non RPA Disturbance/RMA Disturbance:

  21. I certify that I am a licensed professional in the Commonwealth of Virginia and that to the best of my knowledge, in my opinion the proposed development will not result in land disturbance of any nature within a Resource Protection Area (RPA) or exceed two thousand five hundred (2,500) square feet within a Chesapeake Bay preservation Area (CBPA) and that there will be no concentrated flows into a CBPA from a disturbed area of more than two thousand five hundred (2,500) square feet to be located anywhere on the property.

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  23. This field is not part of the form submission.