Any inhabitant of this state may petition the board of supervisors of the county, wherein any indigent person addicted to the excessive use of any intoxicating liquors or of morphia, laudanum, cocaine, opium or other narcotics to such an extent as to become an habitual drunkard, resides, for leave to send such drunkard, at the expense of the county, to any reputable institute for the treatment of such cases, designated by such board of supervisors under the conditions hereinafter contained, which petition shall set forth the name, age and condition of such drunkard, that such drunkard is not financially able to incur the expense of such treatment, and that such habitual drunkard is willing and has agreed to attend such institute for the cure of drunkenness, which petition shall be verified by the person making such request and shall contain in addition thereto the written agreement of such drunkard to take such treatment, if allowed by the board, and a further statement signed by 3 reputable taxpayers of the county, and the supervisor of the township, ward or village, where such drunkard resides, stating that they are familiar with the facts set forth in the petition and with the financial circumstances of the drunkard and that they deem it a proper case for such action by the board of supervisors.