Customer Request Form – Development Compliance
Quick Reference Guide
Form instructions:
Please complete this form by printing clearly with an ink pen. This form should be used only in relation to town planning
matters – non-compliant structures, planning breaches or operational/earth works. Please post to:
Noosa Council
PO Box 141
TEWANTIN QLD 4565
If you are seeking general information with regard to allowable building or planning matters please contact
council on (07) 5329 6500.
1 Your Contact Details
Surname
Given names
Postal address
Street address (including unit/street number)
Suburb
State
Business phone
Postcode
A/H phone
Mobile
Email address
Fax
2. Property address of the complaint (to enable your investigation to commence in a timely manner, please
provide as much detail as possible
Street address (including unit/street number)
Suburb
State
Postcode
If the property is not easily identified (e.g. rural or no visual street numbering), please sketch the property location with
landmarks for easy identification of property (e.g. 3rd house on left from intersection, etc.)
Surname
Given Names
3. Nature of complaint. (What you have observed. Please provide as much detail as possible)
Nature of issue: __________________________________________________________________________________
Summary of issue: PLEASE ATTACH ADDITIONAL PAGES AND PHOTOGRAPHS, IF REQUIRED TO ILLUSTRATE YOUR MATTER.
Onwer/resident details (if known)
Surname
Given Names
Privacy
Council will use any personal information provided for the intended purpose only and for remaining in contact with you. Council is authorised to collect
this information in accordance with the Local Government Act 2009 and other Local Government Acts. Your personal information is only accessed by
persons authorised to do so. Your personal information is dealt with in accordance with council’s privacy policy.
www.noosa.qld.gov.au
PO Box 141 Tewantin Qld 4565
[email protected]
T 07 5329 6500
ABN 97 969 214 121
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Customer Request Form – Development Compliance
Quick Reference Guide
4. Declaration
Please complete the following declaration. This declaration must be completed before any
further action can be taken. Council cannot commit valuable resources to investigate
anonymous complaints.
I________________________________________________ of _____________________________________________
(Full name – printed)
(Full address – printed)
declare that the information recorded in this customer request form is true and correct and that I personally
made these observations.
I understand that not all matters require court action, however, I acknowledge and undertake that should this
matter proceed to court I will be available to appear as a witness for Noosa Council.
Signature
Date
OFFICE USE ONLY
Received:
Date
Received: Records
Date
Date Stamp
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