Noise Nuisance Investigation Request

NOISE NUISANCE INVESTIGATION REQUEST

To enable Council to investigate noise complaints, this form needs to be completed and returned to Council. Theinformation provided will not only assist Council in addressing the complaint, but may form the basis of evidencerequired in the event that the matter is taken to court. Please be advised that should the matter be taken to court,you will be required to act as a witness.

Please submit this form within 3 working days from the date of your last recording using the details below.

For further information or questions regarding this form, please contact Council via 9911 6555.

Complainant Details

First Name *

Surname *

Address *

Postcode *

Contact Number *

Email address *

Details of Noise Nuisance

What is the source of the noise and its description? *eg. piano - very loud?

What is the exact location of the noise source? *eg. property address, landmark etc

How have you confirmed that the noise is from this location? *

How long has this noise been occuring? *

Who is responsible for the noise (if known)? *

Have you spoken to the person responsible for the noise? *

YesNo

What was the outcome? *

Have you personally witnessed the noise occuring? *

YesNo

What would you like to see happen in resolving this complaint? *

Do you give permission for Council to forward your complaint and contact details to other authorities (e.g. NSW OEH) where Council is not the appropriate authority? *

YesNo

If this matter goes to court, you will be required to give evidence. Do you consent to being a witness who will give evidence? *

YesNo

Please complete Council's Noise Nuisance Diary, providing details of the noise nuisance over a 14 day period.

Please upload your Noise Nuisance Diary for a 14 day period. *

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Declaration

I solemnly and sincerely declare that the information above was written by me and is a true and accurate record ofthe observations I made and is a true record of the noise referred to in this complaint. If required I am prepared toact as a witness for Council should the matter go to court. I permanently reside in the premises as described above.

Applicant Name *

Applicant Signature *

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Date *