Customer Request Management Entry

Instructions

Please complete all relevant sections of the form

Please note:
Changing your email address with Council will update all Council email contacts including Rates and Water Notices via email.
Only one email address can be held for the owner of single or multiple properties.

Water Hydrant Testing - Online

Description *

Enter a brief description of your request

Property Address

Enter some or all of the property details below. If searching by street name, enter the street name only (e.g. Spence); do not include the street type or suffix (e.g. St, Road, Ave etc). Alternatively you can search by Lot or RP number. Then click the Search button to proceed to the property results screen where you can confirm the address.

Building Name

Unit No.

Level No.

House No.

Street Name

Suburb

Title Type

Title 1

Title 2

Title 3

Title 4

Title 5

Title 6

Street Name

Select a Suburb and Street the call is in relation to.

Select Street

Select Suburb

Street Number or Nearest Cross Street or Additional Location Information

Enter a description of the location related to the call.

Description

Customer Contact Details *

Customer

Name

Code

Surname *

Given Name * / Second Name

Contact Details

Postal address

Street address line 1 *

Street address line 2*

Street address line 3

Postcode *

Postal address if different from residential

Street address line 1 *

Street address line 2*

Street address line 3

Postcode *

Work phone

Home phone

Mobile phone

Email address *

Alternate phone

What is your preferred method of contact?

Not required

Telephone

Contact Name and Phone Number (Required)

Further Location Details

Please re-confirm the contact email address (Required)

I have read and accept the terms and conditions of use for Council's online self services

Yes

Attach photos, documents etc.

Browse for an attachment to link to this application

/eservice