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Exhibit D <br />Pole Attachment Removal Notification <br /> <br /> <br /> <br /> <br />Application Reference _______________________ <br /> <br /> <br />Public Utility District No. 1 of Snohomish County (“Licensor”) and _________________________ <br />(“Licensee”) entered into a Pole Attachment License Agreement (“Agreement”) (dated <br />_________________ ) that allows the Licensee to install and locate certain attachments on District utility <br />poles. In accordance with the terms and conditions of said Agreement, Licensee hereby provides notice to <br />the District that it intends to remove all of its attachments(s) on District utility pole(s) as marked/shown <br />(including pole number) on the attached map(s)/sketch(es). Said attachments shall be removed by <br />___________________ . Licensee acknowledges that under the Agreement, it shall be charged and is <br />responsible for pole attachment charges through the end of the month in which this notice is given and/or <br />the attachments have been removed (whichever is later). <br /> <br /> <br /> <br />Licensee: ____________________________________ <br />By: __________________________________________ <br />Title: ________________________________________ <br />Date: ________________________________________ <br /> <br /> <br />Licensor <br />Notification Received and Accepted by: <br />_____________________________________________ <br />By: _________________________________________ <br />Title: ________________________________________ <br />Date: ________________________________________ <br />PO Box 1107 <br />Everett, WA 98206