Online Form - Environmental Health Complaint

Please note this online form is for reporting public health problems within the Town of Cottesloe only. While every effort will be made to resolve your request in a timely manner, please understand the Town has limited resources and environmental health issues will be dealt with in order of priority. Your details will be kept confidential where possible, however the Town of Cottesloe is subject to the Freedom of Information Act. All barking dog complaints should be directed to Ranger Services.

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Name *

Address

Street Address:

City:

State:

Post Code:

Country:

Email *

Phone Contact *

I confirm that I am prepared to attend Court and give evidence should legal action be taken *

YesNo

Address of property in the Town of Cottesloe creating a nuisance *

Nature of the Nuisance *

Frequency of Issue *

Time of Day the issue occurs

Details of the Issue (including how the issue affects your amenity) *

Have you attempted to resolve this matter

YesNo

Please provide details of any attempt you have made to resolve the issue. For example, have you contacted police or spoken with the property owner or tenant. If possible, please include contact details for anyone you have spoken with. *

I confirm the information I am submitting is true and correct *

YesNo

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Online Form - Environmental Health Complaint

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